COVID-19 Screening Questions

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Please answer all of the questions below each day prior to your child's arrival at Gesstwood Camp. Thank you!

Camper Name: *

Cabin # *

Phone Number *

In the last 14 days, has the student/child travelled outside of Canada? *

Yes

Has a doctor, health care provider, or public health unit told you that the student/child should currently be isolating (staying at home)? *

Yes

In the last 14 days, has the student/child been identified as a “close contact” of someone who currently has COVID-19? *

Yes

Is the student/child currently experiencing any of these symptoms? Choose any/all that are new, worsening, and not related to other known causes or conditions they already have. (Select all that apply or select NONE) *

NONE

Cough or barking cough (croup)

Shortness of breath Out of breath, unable to breathe deeply

Decrease or loss of taste or smell

Sore throat or difficulty swallowing Painful swallowing

Runny or stuffy/congested nose

Headache Unusual, long-lasting

Nausea, vomiting and/or diarrhea

Extreme tiredness or muscle aches

Required

Is someone that the student/child lives with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms? If the individual experiencing symptoms received a COVID-19 vaccination in the last 48 hours and is experiencing mild headache, fatigue, muscle aches, and/or joint pain that only began after vaccination, select “No.” *

Yes

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