Orange and Black Attendance

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Game/ Practice Date *

YYYY

Name *

Will you be at the Game/ Practice? *

Yes

Do you have 1 or more of the following symptoms? Fever of 100.4 or more, chills, new cough, shortness of breath, headaches, loss of taste, or sore throat. If you answer yes to any of these please consult with trained medical professionals to determine if you need further testing. *

Yes

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