Maui Prep Student-Athlete & Staff COVID-19 Test Results Reporter

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The Hawaii Department of Education issued a memo on 6/14/22 stating that in order to participate in athletics, all students, coaches, & athletic support staff must be one of the following:
-Fully vaccinated (i.e., two weeks after the final dose of the COVID-19 vaccine primary series)
OR
-Are required to participate in a once a week COVID-19 testing utilizing a test taken through a CLIA-certified laboratory or under an approved CLIA Certificate of Waiver or a home-based test that is authorized for use by the FDA.

A google form must be submitted each week and will be checked on Friday. Failure to report your test results during the week will make you, or your student athlete ineligible to practice and play/ coach in the following week's practices and games.

***If you test positive please contact Dr. Zamora, Miss Figueroa & Coach Bailey immediately.

Email *

Name of the adult/guardian filling out this form *

Last Name, First Name (Example - Doe, Jane)

Name of person being tested (Last Name, First Name) *

Example - Smith, John

Grade / Position *

Date of test *

YYYY

Type of test *

Results of test *

I certify that the information I am providing is true and accurate and that the test taken had a negative result and was taken through a CLIA-certified laboratory OR under an approved CLIA Certificate of Waiver OR a home-based test that is authorized for use by the FDA. *

I acknowledge and certify that the information I am providing is true and accurate.

I acknowledge that it is wrong to falsify and/or inaccurately report test results and that doing so will lead to sanctions against participation. I also accept full responsibility if any members of the team are being harmed in any way due to such actions. *

I acknowledge this statement and accept full responsibility from reporting false information.

A copy of your responses will be emailed to the address you provided.

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