GFLL Umpire Check-In and Health Check

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We need each umpire to complete this form prior to arriving at a game they are working. This will serve as their record of attendance for payroll purposes, as well as adherence to the GFLL COVID-19 protocols. If you answer "Yes" to any of the questions below, please do not attend the game. Instead, call Dan Ryan (703-867-7934), right away so that we can identify a back-up umpire, or better yet, perhaps you can work on helping her find a replacement as well.

By hitting submit, you are certifying that the information contained within this form is true and accurate.

Umpire First Name *

Umpire Last Name *

Date of game *

YYYY

Division Playing *

Softball AA

Softball AAA

Baseball AA

Baseball AAA

Baseball Majors

Umpire Position *

Plate Umpire

Base Umpire

Have you experienced a fever of 100.4˚F or greater in the past 10 days? *

Yes

Have you received a positive result from a COVID-19 test within the past 14 days? *

Yes

Have you been in contact with anyone while they had COVID-19 or symptoms of COVID-19 in the past 14 days? *

Yes

Have you experienced any of the following symptoms within the past 14 days? *

Cough

Shortness of breath

Sore throat

Runny nose

None of the above

Required

Submit

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