thinkLAX Symptom Checker Form

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This form must be completed 24 hours before any thinkLAX event you attend. Required for participation in any thinkLAX practices, camps or clincs. This is includes Rebels, Renegades, and Maryland Select.

All of our staff will be trained prior to any scheduled event for our company.

Email *

Player Name *

Current Temperature Reading *

Date of Activity you are participating in: *

YYYY

Team you Play For *

Location of Play *

I certify that I am Symptom Free for the Following and have had no close contact with anyone with COVID-19. *

Shortness of Breath or difficulty breathing

Chills

Repeating shaking with chills

Muscle Pain

Headache

Sore Throat

Loss of Taste or Smell

Diarrhea

Feeling feverish or a measured temperature greater than or equal to 100.0 degrees Fahrenheit

Known close contact with a person who is lab confirmed to have COVID-19

Required

Please acknowledge: There will be enhanced risks of all participants to all parents, parents and guardians for participants being in direct contact with anyone age 65 or older for 14 days after participating in a sport event or practice. *

I acknowledge and will not visit anyone 65 years or older or anyone considered "at risk" for 14 days after my participation.

Required

A copy of your responses will be emailed to the address you provided.

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