COVID-19 Response Form

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This form should be completed by any Match Fit Academy player that is unable to pass the TeamSnap Health Check.

Upon receipt of this form, Match Fit Academy will review and provide a return to play date. All decisions on return to play date are made based upon CDC, State of NJ, NJ Youth Soccer and local health department recommendations and guidance.

Player Name *

Player Team *

2013 Morris

2012 Morris

2011 Blue

2011 White

2010 Blue

2009 Blue

2009 White

2008 ECNL

2008 ECRL

2007 ECNL

2007 ECRL

2006 ECNL

2006 ECRL

2005 ECNL

2005 ECRL

2004 ECNL

2004 ECRL

2003 ECNL

2003 ECRL

2011 Shore

2009 Shore

2007 Shore

2003 Shore

Best Email to communicate with family *

What is the issue? *

Possible exposure

Close contact to positive person

Symptoms

Other sickness

Travel out of NJ

Please provide more details (include dates, type of contact/symptoms, where you travelled etc...) *

What was the date of exposure, start of symptoms/sickness or return to NJ *

YYYY

Do you plan on taking a PcR test? *

Yes

If you took a PcR test and it was negative, please give the date the negative test was administered.

YYYY

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