Kinsmen Moose Jaw Speed Skating Club COVID-19 Screening Form

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We require you to answer the questions below to assist the Kinsmen Moose Jaw Speed Skating Club in determining your fitness to train during COVID-19.

Ensure at all times you are following protocols for hand hygiene and also remember to clean your keys, phone, and other personal items.

We are not screening for seasonal or environmental allergies; related symptoms to these scenarios would not preclude you from training. The following questions are meant to capture new symptoms, or a worsening of long-standing symptoms.

Last Name *

First Name *

Are you the Skater's Parent/Guardian? *

Yes

Date *

YYYY

Time *

Time

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