Football - Athlete - COVID-19 Screening

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This form is to be completed by each athlete daily prior to participating in athletic activity.
Participation is completely optional and is not a requirement for trying out for the high school team.
Go Panthers!

I have been informed that participation is completely optional and is not a requirement for trying out for the high school team. *

Acknowledged

Pod Number *

First Name *

Last Name *

Date *

YYYY

Do you have any of the following symptoms *

Fever in the last 24 hours of over 100.4

Cough

Shortness of Breath

Sore Throat

New Loss of Smell or Taste

Chills

Muscle Pain

Headache

I show no signs of any of the above

Required

Are you ill or caring for anyone who is ill? *

Yes

Required

Have you been in contact with anyone with COVID-19 in the past 14 days? *

Yes

Not to my knowledge

Required

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