2021 MNLL COVID-19 Health Screening Questionnaire
Players should complete and submit this form before every MNLL event (including player evaluations, practices, games and meetings) NOT SOONER THAN 24 HOURS PRIOR.

If any player exhibits any symptoms during the MNLL event, they will be isolated until their parent/guardian is able to pick them up. Temperatures will be taken before every event. Anyone with a temp 100.4 degrees or higher will be asked to go home.

**PLEASE NOTE: If you answer "Yes" to any of the questions below, please stay home and DO NOT attend the MNLL event. League Safety Officer, Ryan Keefe, will contact you regarding next steps.
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Player / Volunteer Full Name *
MNLL Division *
Type of MNLL Event (should be taking place within 24 hours of completing this form) *
Did you recently travel outside of California? *
Within the last 10 days, have you been diagnosed with COVID-19 or had a test confirming you have the virus? *
Within the past 14 days, have you had close contact with, someone who has been in isolation for COVID-19 or had a test confirming they have the virus? (Close contact is less than 6 feet for 15 minutes or more.) *
Have you had any one or more of these symptoms today or within the past 3 days? (*Fever or chills, *Cough, *Loss of taste or smell, *Shortness of breath or difficulty breathing) *
Have you had any one or more of these symptoms today or within the past 3 days and that are new or not explained by another reason? (*Fatigue, *Muscle or body aches, *Headache, *Sore Throat, *Nausea, vomiting or diarrhea) *
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