Volunteer COVID Screener - 2021 Spring Season
In accordance with NY State requirements for recreation operations, all BPR Baseball volunteers (Head Coaches, Assistant Coaches, 3rd and 4th Coaches, Safety Monitors) are required to complete this health screen
1) EACH TIME they are volunteering,
2) ON THE DAY they are volunteering
3) PRIOR to appearing at the ball field.

The purpose of this screener to enable the state's contact tracing efforts in the case of a positive test or outbreak.

If you answer Yes to any of these questions, please notify BPR Baseball (bprbaseballassoc@gmail.com) and contact your health provider.
Sign in to Google to save your progress. Learn more
Volunteer First Name *
Volunteer Last Name *
Division / League *
Date Volunteering *
MM
/
DD
/
YYYY
Have you knowingly been in close or proximate contact in the past 14 days with anyone who has tested positive for COVID-19 or who has or had symptoms of COVID-19 in the past 14 days? *
Have you been in close or proximate contact in the past 14 days with anyone who has been asked to quarantine due to potential exposure to COVID-19 in the past 14 days? *
Have you tested positive for COVID-19 in the past 14 days? *
Have you experienced any symptoms of COVID-19 in the past 14 days? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy