HEALTH SCREENING & TEMPERATURE CHECK
HOLT RAMS CROSS COUNTRY 2021

* This form MUST be completed by athletes/parents prior to attending any workout, practice, meet, or team gathering. No Exceptions. We understand that this is a tedious task on a daily basis but it is a requirement in order to practice, compete, and have a season.

Please contact either of head coaches if you have questions, concerns, and/or need assistance.

CONTACT INFO:
Ross Malatinsky
Men's Coach
Holt HS - Cross Country / Track & Field
rmalatin@hpsk12.net

Jonathan Watson
Women's Coach
Holt HS - Cross Country / Track & Field
jonathan.watson@hpsk12.net
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First Name *
Last Name *
Team *
Gathering Type *
PRE-SCREENING QUESTIONS
In the past 24-48 hours have you experienced ANY of the following symptoms/conditions?
Fever, Cough, Sore Throat, Shortness of Breath, Close Contact and/or Care for someone with COVID-19? *
If (YES) to ANY of the above symptoms, which one(s)
Temperature (If higher than 100.3' F)
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