TASL COVID-19 REPORTING FORM

TASL COVID-19 REPORTING FORM
Name

First NameLast Name
Phone #

Area CodePhone Number
Email
example@example.com
Team Name
Team Division
I am submitting this COVID-19 Reporting Form because one or more of the following apply:
If you have tested positive or have experienced symptoms of COVID-19 in the last 5 days, did you participate in any TASL activities during that time (the last 5days)?
Date of Positive Test or Onset of Symptoms

MonthDayYear
Date
Date of TASL Event

MonthDayYear
Date
Players Names and Contact Information
I understand that I am not eligible to play in TASL until the TASL Administrator has cleared me to resume TASL-related soccer activities and has informed me of my Return to Play date.

If additional information is required, I understand that the TASL Administrator will contact me, and I will not be cleared to resume TASL-related soccer activities until I have provided the requested information.

I understand that I may be cleared for an earlier Return to Play date if I receive a negative COVID-19 test or if I receive confirmation of an alternative diagnosis from a health care provider that would explain the COVID-19 symptom(s), by providing the test result or proof of diagnosis to the TASL Administrator, and if I have had no fever without the use of fever-reducing medication for 24 hours.
Should be Empty: