ROW Swim Club Assessment Days - Health Attestation Form

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Mandated COVID19 Health Screening and Contact Tracing Questionnaire

Please fill out this Form for each Swimmer participating in the ROW Swim Club Assessment, each time they swim.

School aged swimmers should pass the Ontario School Screener, receive a green check mark and answer YES to the question below before coming to the pool - https://covid-19.ontario.ca/school-screening/

Email *

Date of Swim Session *

YYYY

Swimmer’s Last Name *

Swimmer’s First Name *

Has your swimmer completed the Ontario School Screener and received a "green check mark" indicating they are safe to come to the pool?https://covid-19.ontario.ca/school-screening/ *

Yes

Name of parent filling in this questionnaire *

Submit

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