MOT Charter Officials & Guest COVID Screening Form

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Keeping all students and staff healthy during the 20-21 Academic Year is our most important priority. Please answer the following questions.

THIS FORM MUST BE COMPLETED FOR ALL SPECTATORS INCLUDING MINOR CHILDREN.

Please Note: Both HOME and VISITING Team Spectators must complete this form prior to being permitted on the MOT Charter HS Campus.

Email *

Please Select the Sporting Event you are attending today: *

Please identify your student athletes school (i.e, MOT Charter, Newark Charter, MHS, St. Georges, etc., ) *

First and Last Name of Spectator *

Spectator Phone Number *

Confirmation of Age *

Adult (Ages 18 and Older)

Student/Child (Infant- 17 years old)

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