ABRA Program COVID-19 Health Assessment :
Name Of Participant / Child
Name Of Second Participant / Child (If Applicable)
Ball Hockey (5-7, 8-12)
Easter Basket Floral Workshop
Engineering for Kids: Jr. Makey Makey (6-8)
Engineering for Kids: Python Coding (9-14)
Junior Tennis (4-6, 7-12)
Little Medical School (4-6, 7-12)
Multi-Sport (3-5) - Afternoons
Multi-Sport (3-5) - Evenings
Multi-Sport (3-5) - Mornings
Parented Multi-Sport (2-3) - Evenings
Parented Multi-Sport (2-3) - Mornings
Prince Basketball (5-7, 7-9, 9-12)
Salsa Date Night Workshop (16+)
Yoga Flow (16+)
State / Province
Have you, or anyone in your household, traveled outside of Canada in the past 14 days?
Have you, or anyone in your household, tested positive for COVID-19 in the past 14 days?
Are any members of your household currently experiencing any of the following symptoms: fever above 38 degrees Celsius, cough, shortness of breath/difficulty breathing, sore throat, runny nose?
Do you understand and consent to the terms outlined in the COVID-19 lake use information sheet (https://bit.ly/2XZiIwO)?
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