LTTTC COVID-19 Screening Questions

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Players or parents (if the player is under the age of 18) must sign our liability waiver and are required to fill out this form before returning.

Email *

Do you have any COVID-19 symptoms, such as fever, shortness of breath, or cough? *

Yes

Does anyone in your family or close contacts show any COVID-19 symptoms? *

Yes

Have you been advised to self-quarantine because of exposure to someone with COVID-19? *

Yes

Have you traveled in the past 14 days to any regions impacted by COVID-19? *

Yes

Have you tested positive for COVID-19 in the past 14 days? *

Yes

Are you over the age of 65? *

Yes

Do you have any of the following: *

Heart disease

Lung disease

Kidney disease

Diabetes

None of the above

Which club activity were you previously associated with? *

Beginner Team

Advanced A/B Team

Elite Team

UC San Diego

Adult Beginner/Advanced Group

Open Play/Club Member

Private Lessons

Other

Which date do you expect to return? *

At the earliest date possible

September

October

November

After the pandemic ends (TBD)

I do not plan on returning

Send me a copy of my responses.

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