COVID Screening
Players and Parents are required to fill this out before every practice by 4PM in order to participate
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Email *
Date *
MM
/
DD
/
YYYY
Parent/Guardian Name *
Player's Name *
In the past 14 days have you experienced? *
Yes
No
Fever greater than 100 degrees F
Dry cough
Shortness of breath
Sore throat
Muscle aches/pain
Congestion/runny nose
Chills
Fatigue for unknown reason
Loss of taste and smell
Nausea,vomiting, or diarrhea
In the past 14 days have you? *
Yes
No
Tested positive for COVID or awaiting test results?
Traveled out of state /internationally or has been in close proximity to someone who has recently traveled from out of state/internationally
Been in close proximity to someone who has tested positive for 15min or more
Been in close proximity to person exhibiting COVID symptoms for 15min or more
I have answered these questions to the best of my knowledge. For the safety of everyone at tryouts, I will not attend practice if I have answered yes to any of the questions. *
Required
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