In Season - Daily Symptom Tracker Form

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This form must be completed prior to arrival on campus by a parent/guardian of each student-athlete each day

Date *

YYYY

Name of Athlete *

Sport *

Golf

Softball

Cross Country

I have read and agree to adhere to all Holy Family High School and the CHSAA Athletic Guidelines *

Yes

Does the athlete have a fever of 100.4 or higher? *

Yes

Does the athlete have a dry cough? *

Yes

Does the athlete have shortness of breath? *

Yes

Does the athlete have a sore throat? *

Yes

Does the athlete have a head ache, body aches, or chills? *

Yes

Does the athlete have vomiting, diarrhea, or nausea? *

Yes

Does the athlete have loss of taste or smell? *

Yes

Does the athlete have a runny nose? *

Yes

HFHS requires anyone: (i) who is a member of a vulnerable population; (ii) who is sick; (iii) who has tested positive for COVID-19; (iv) who is awaiting COVID-19 test results; (v) who has symptoms of COVID-19; or (vi) who has, been around anyone sick within the last 2 days of scheduled programming, had close contact with a person with COVID-19 . . . . . to stay home and not participate at present. Does the athlete meet any of the aforementioned criteria? *

Yes

Electronic Signature - everything included in the Form is accurate to the best on my knowledge. *

Submit

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