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Accelerate Sports Covid-19 Daily Screening Form
This health screening is mandatory for any party wishing to enter Accelerate Sports property. Please screen shot proof of submission on the next page and show to the Accelerate front desk staff member upon entering the building.
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* Indicates required question
Email
*
Your email
Participant's First and Last Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
First and Last name of any other member of your party (parents, spectators, siblings etc). If not applicable type NONE
*
Your answer
Today's Date
*
MM
/
DD
/
YYYY
Anticipated Time of Entry
*
Time
:
AM
PM
Sport
*
Soccer
Baseball/Softball
Basketball
Volleyball
Fitness
Boxing
Field Hockey
Other
COVID-19 symptoms
Fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of tased or smell, sore throat, congestion or runny nose, nausea, diarrhea or vomiting.
Have you or any member of your party had any of the above symptoms of Covid-19 in the past 14 days?
*
Yes
No
Have you or any member of your party been in close contact with a confirmed or suspected COVID-19 case in the past 14 days?
*
Yes
No
A copy of your responses will be emailed to the address you provided.
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