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2022 BTSH Attendance & COVID-19 Form
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Team
*
Choose
Agents
Bad Seeds
Butchers
Cobra Kai
Corlear's Hookers
Dark Rainbows
Denim Demons
Filthier
Fresh Kills
Fuzz
Gouging Anklebiters
Gremlins
Instant Karma
Lbs Inc.
Mega Touch
Poutine Machine
Sky Fighters
Thompkins Square Riots
Vertz
What the Puck
Free Agent (Sub)
COVID 19: Regardless of your vaccination status, have you experienced any of the symptoms in the list below in the past 48 hours?
*
Fever or chills
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomitting
No symptoms
Required
COVID 19: To the best of your knowledge, have you or anyone in your household been directly exposed to COVID-19 in the last 48 hours?
*
Yes
No
COVID 19: If you marked YES to exposure, please elaborate.
Your answer
Free Agents Only - What team are you subbing for?
Choose
Butchers
Corlear's Hookers
Dark Rainbows
Denim Demons
Filthier
Fresh Kills
Fuzz
Gouging Anklebiters
Gremlins
Instant Karma
Lbs Inc.
Mega Touch
Poutine Machine
Sky Fighters
The Agents
The Bad Seeds
Thompkins Square Riots
Vertz
What the Puck
Game Date
*
Choose
November 13
A copy of your responses will be emailed to the address you provided.
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