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COVID-19 QUESTIONNAIRE-Summer Workouts
To be completed by Parent/Guardian 7 days prior to your child beginning summer workouts. If this form is not completed, your child will not be permitted on campus and attend workouts.
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* Indicates required question
Student-Athlete's Full Name (Last, First)
*
Your answer
Summer Workout Sport
*
Choose
Girls Soccer
Football
Marching Band
Field Hockey
Parent/Guardian Name
*
Your answer
Parent/Guardian Best Contact Number
*
Your answer
Has your son/daughter been diagnosed with Coronavirus (COVID-19)?
*
Yes
No
If diagnosed with Coronavirus (COVID-19), was your son/daughter symptomatic?
*
Yes
No
N/A- Only select this if you answered NO to your child being diagnosed with Coronavirus (COVID-19)
If diagnosed with Coronavirus (COVD-19), was your son/daughter hospitalized?
*
Yes
No
N/A- Only select this if you answered NO to your child being diagnosed with Coronavirus (COVID-19)
Has any member of the student-athlete's household been diagnosed with Coronavirus (COVID-19)?
*
Yes
No
Checking the box below affirms your answers are true and you are the Parent/Guardian of the student named above.
*
Accepted by Parent/Guardian
Required
Today's Date
*
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/
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