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Oaklea Middle School Facility Use Check-In
OSAA Reopening Phase 2 Guidelines specify that all coaches and students should be screened daily for signs/
symptoms of COVID-19 prior to participating. This form must be completed for EACH sport/activity the participant will be involved in that day.
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Email
*
Your email
What is today's date
*
MM
/
DD
/
YYYY
Group(OMS sport team, Athlete from visiting team, school and sport, Spectator/event e.g. varsity soccer)
*
Your answer
Symptoms checklist: Fever of 100.4 F or higher; chills; shortness of breath; new loss of taste or smell; nausea/vomiting/diarrhea
*
Yes
No
Have you had close contact (within 6 feet for a least 15 minutes) with someone diagnosed with COVID-19 in the last 14 days? (There are some exceptions to this, so please contact Nurse Carol
epuderbaugh@junctioncity.k12.or.us
if you have questions.
*
Yes
No
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