Webb Moffett 2021 Health Screening Form

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Daily completion of this waiver by all athletes, coaches, officials, and volunteers is mandatory and must be completed by each participant or legal guardian by 8 PM the night before the competition and before 7 AM the day of the competition. Anyone who does not sign the Webb Moffett 2021 Health Screening Form will not be allowed to participate in the competition.

Day *

YYYY

Last Name *

First Name *

Email *

Phone *

Have you had any of the following symptom in the last 24 hours? *

Cough

Fever 100.4*F or higher or chills

Shortness of breath or difficulty breathing

Fatigue

Muscle or body aches

Headache

New loss of taste or smell

Sore throat

Congestion or runny nose

Nausea or vomiting

Diarrhea

None of the above

Other:

Required

Have you been in close contact with anyone who has Covid-19? *

YES

Have you traveled out of state in the last 15 days? *

YES

If yes to travel, where did you go?

All athletes, coaches, officials, and volunteers are expected to respectfully comply with US Ski and Snowboardʻs COVID-19 protocols with regard to facial coverings and social distancing *

I agree to adhere to US Ski and Snowboards COVID-19 protocols

Required

All athletes, coaches, officials, and volunteers are expected to respectfully comply with Summit at Snoqualmie guidelines and requirements with regard to facial coverings and social distancing *

I agree to adhere to Summit at Snoqualmie guidelines and requirements in regards to COVID

Required

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