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Daily Health Attestation for Varsity Athletics
Complete the form below each day prior to practice or games
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Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Grade
*
7
8
9
10
11
12
Sport
*
Football
Girls Volleyball
Girls Swimming
Boys Soccer
Field Hockey
Girls Cross Country
Girls Tennis
Level of Competition
*
Varsity
Junior Varsity
Modified (Junior High)
Are you experiencing shortness of breath?
*
Yes
No
Have you had a temperature higher than 100.0 degrees Fahrenheit in the past ten days?
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Yes
No
Are you in close contact with someone currently diagnosed with COVID-19?
*
Yes
No
Have you been in close contact with someone currently diagnosed with COVID-19 in the past ten days?
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Yes
No
Have you traveled within a state with significant community spread of COVID-19 for longer than 24 hours within the past 10 days? Note: For a list of states currently under New York’s travel advisory requiring a 10-day quarantine upon return, please visit:
https://coronavirus.health.ny.gov/covid-19-travel-advisory#restricted-states
*
Yes
No
By entering my full name below I acknowledge that my answers to the above questions are true.
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Your answer
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