BSC Academy Sessions COVID-19 and General Health Screening Form
Please provide the following information BEFORE arriving and attending a BSC session.

Spectators ARE NOT Permitted.

RINK B - Main Entrance through LEFT doors

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Role *
First Name *
Last Name *
Skating Session  - Date/Time  - Check all that apply - All sessions at HRM 4 PAD (BMO Centre) *
Required
Are you or any member of your household required to isolate as per Nova Scotia Health requirements? *
If yes, the participant is not permitted to attend BSC events for 14 days from the date of the return until the end of the isolation period.
Required
Have you or any member of your household been at an exposure site? *
If yes, the participant is not permitted to attend BSC events until a negative COVID-19 test has been received and the club has been informed.
Required
In the past 48 hours have you had, or are you currently experiencing, any of these symptoms? *
If yes, the participant is not permitted to attend BSC events until symptoms have disappeared or a negative COVID-19 test is provided.
Yes
No
A fever (i.e. chills/sweats) OR Cough (new or worsening)
Two or more of the following symptoms (new or worsening) - Sore throat, Runny nose/nasal congestion, Headache, Shortness of Breath
Do you feel unwell today? *
If yes, the participant is not permitted to attend BSC sessions.
Submit
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