Program Leader/Coach COVID Health Assessment Certification and Protocol Compliance

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Each Program must certify for all kids attending each DVLL Play Day that none of their players have answered "Yes" to any of the following questions

What Program are you submitting for? *

What is your first and last Name? *

What is your Email and Phone #? *

What is the date of the Play Date you are certifying for? *

YYYY

Have any of the players/coaches on the DVLL teams you are certifying for this play day experienced a fever of 100.4ºF or greater in the past 14 days? *

Have any of the players/coaches on the DVLL teams you are certifying for this play day received a positive result from a COVID-19 test within the past 14 days? *

In the past 14 days, Have any of the players/coaches on the DVLL teams you are certifying for this play day, been in close contact with anyone that has or had symptoms of COVID-19 that required them to quarantine? *

In the past 14 days, Have any of the players/coaches on the DVLL teams you are certifying for this play day or someone they have been in close contact with traveled to an area that required quarantine upon return? *

In the past 14 days, Have any of the players/coaches on the DVLL teams you are certifying for this play day, experienced any of these symptoms that are not attributed to another health condition: cough, loss of smell or taste, runny nose, shortness of breath, or a sore throat? *

All our families/coaches are aware of the 1 spectator rule? *

YES

All our families/coaches are aware of the PA Mandate on mask wearing for players *

YES

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