Boys Lacrosse Winter Indoor Covid-19 Survey

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Please fill this out on the days that your son is participating in our Winter Indoor Lacrosse programs by 1:00 pm

Player/Coach Last Name *

Player/Coach First Name *

Player Grade or Coach *

Have you had COVID-19 symptoms in the past 14 days? ( The current CDC definition of symptoms includes: fever, cough, shortness of breath, or at least two of the following symptoms: fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or NEW loss of taste or smell) *

Yes

Have you had a positive COVID-19 test in the past 14 days? *

Yes

Have you had close contact with a confirmed or suspected COVID-19 cases in the past 14 days? *

Yes

Has the participant spent 24 hours or more in any of the states listed on New York State's Travel Advisory list. (https://coronavirus.health.ny.gov/covid-19-travel-advisory) * *

Yes

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