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COVID-19 Screening
If you answer yes to any of the following questions we ask that you please do not attend the competition. Thank you for your cooperation.
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* Indicates required question
Date:
*
MM
/
DD
/
YYYY
First and Last Name(s):
*
Your answer
Email address:
*
Your answer
Do you, a family member or significant person you are in contact with have any of the following symptoms?
*
Fever or feverish
new or worsening cough
shortness of breath
sore throat or difficulty swallowing
chills
headaches
nausea/vomiting, diarrhea, abdominal pain
conjunctivitis (pink eye)
loss of taste or smell
None of the above
Required
Have you, a family member or significant person you are in contact with, travelled outside of Canada or had contact with anyone who has travelled outside of Canada in the last 14 days?
*
Yes
No
Have you, a family member or significant person you are in contact with, been required to isolate?
*
Yes
No
Have you, a family member or significant person you are in contact with, had close contact with anyone with respiratory illness or a confirmed or probable case of COVID-19?
*
Yes
No
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