Russell Minor Hockey Association - COVID Screening for Spectators
This form is only valid if completed on the day of the time you're spectating.  A new form must be filled out for each ice time you spectate.  Only one form is required per household.
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Email *
Spectator's First and Last Name *
Other Spectator's names within your household. (First and Last Name separating each with a comma)
Direct Contact Phone Number for Person Filling Out Form *
On-Ice Player You're Accompanying? *
What age group does your child play in? *
Date of ice-time/session pertaining to this form? *
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In the last five days have you experienced any of these symptoms? Fever and/or Chills (37.8C+), Cough or Croup (more than usual, wheezing and not related to pre-existing conditions), Shortness of Breath(not related to asthma), Decrease or loss of taste or small (not related to allergies, neurological disorders), Nausea, Vomiting and/or Diarrhea (not related to irritable bowel, anxiety or menstrual cramps), extreme fatigue or muscles aches (not related to depression, insomnia, thyroid disfunction or sudden injury)? *
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