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Health Screen Questionnaire
Please fill this form out before you attend a MAPS sponsored event. Please fill out to the best of your knowledge.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last name
*
Your answer
The athletic or activity event you are attending right now.
*
Band or Color Guard (Wilk)
Baseball (Schultz)
Basketball-Boys (Shalow)
Basketball-Girls (Smith)
Cheer (Howard)
Choir (Olson)
Cross Country (Swan)
Dance (Schulz)
Football (Klug)
Golf (Plisch)
Hockey (Marlowe)
Soccer-Boys (Watzka)
Soccer-Girls (Korff)
Softball (Ellenbecker)
Strength & Conditioning (Arneson)
Swimming (Winter)
Tennis (Barton)
Track & Field (Wadzinski)
Volleyball (Krug)
Wrestling (Suchocki)
Other:
A copy of your responses will be emailed to the address you provided.
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