Health Acknowledgement

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Each player MUST complete this form between 24 hrs-12 hrs before each event. If you answer YES to any of the questions below you must change your RSVP to NOT GOING and notify Caleb Olson immediately. Your RSVP means that have read and agree to the COVID-19 Liability Waiver found on the Meetup event description.

Full Name *

Phone Number (Including Area Code) - Contact Tracing Only *

Game Location *

I have had COVID- 19 symptoms in past 14 days, which may include a fever of 100.4 degrees Fahrenheit or greater, a new cough, new loss of taste/smell, shortness of breath or difficulty breathing, muscle/body aches, fatigue, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea). *

Yes

I have had a positive COVID-19 test in the past 14 days, measured from the test date, not the date that the test result was received. *

Yes

I have been in close contact (within six feet or less for at least 10 minutes) with confirmed or suspected COVID-19 case in past 14 days. *

Yes

I have traveled out of the state or country within the last 14 days. *

Yes

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