Renegades Lacrosse - Wellness Check
Boys Lax - 6th Grade
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Name of Athlete *
In the past 24 hours, has the Athlete/Coach or any member of their household had any of the following: cough, fever over 100.4F, vomiting, nausea, diarrhea, sore throat, or shortness of breath?  Is the Athlete/Coach or any member of their household waiting for COVID-19 test results?  In the past 14 days, has the Athlete/Coach been in contact with someone testing positive for COVID-19?  Is the Athlete/Coach recommended to quarantine per CDC guidelines for any reason? *
Enter the name of the Parent or Guardian completing this form on behalf of the Athlete/Coach.  I certify that this form was completed accurately. *
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