Daily Health Questionnaire

Daily Health Questionnaire
Where is your session being held?

SNIPE Academy Cambridge (389 Clyde Rd.) Cambridge Sports Park (1001 Franklin Blvd.) Ayr - North Dumfries Community Centre (2959 Greenfield Rd.)
Cambridge Sports Park requires all participants to complete their own sports waiver. This only needs to be completed 1 time. Have you already completed the Buckingham Sports Waiver for your child?

Yes No
Please use the QR Code or the link below to complete the Buckingham Sports Waiver.

https://form.jotform.com/210555941473053

2. In the last 14 days, has your child been in close physical contact with someone who tested positive for COVID-19? (close physical contact means being less than 2 metres away in the same room, workspace, or area for over 15 minutes or living in the same home) *

Yes No
2. In the last 14 days, have you been in close physical contact with someone who tested positive for COVID-19? (close physical contact means being less than 2 metres away in the same room, workspace, or area for over 15 minutes or living in the same home) *

Yes No
Have you received public health or medical advice to self-monitor or self-isolate? *

Yes No

Date *

Month Day Year
Date
By providing answers to this questionnaire and signing below, you confirm that all answers are accurate. *

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