Form
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Yes
No
Do you have any of the following Covid-19 symptoms:
Which public skate/shinny would you like to register for:
January 29 12:00-1:00 PM
January 29 1:15 - 2:15 PM
January 29 19th 2:30- 3:30 PM
February 1 12:00-1:00 Pm
February 1 1:15 - 3:15 PM
February 1 3:30-5:30 PM
February 8 2:00-4:30 PM
February 16 12:00 - 1:00 PM
February 16 1:15 - 2:15 PM
February 16 2:30-3:30 PM
February 17 12:00 - 1:00 PM
February 17 1:15 - 2:15 PM
February 17 2:30-3:30 PM
February 18 12:00 - 1:00 PM
February 18 1:15 - 2:15 PM
February 18 2:30-3:30 PM
February 19 12:00 - 1:00 PM
February 19 1:15 - 2:15 PM
February 19 2:30-3:30 PM
February 22 2:00 - 4:30 PM
February 15 4;45 - 6:30 PM
February 22 4:45- 6:30 PM
Has anyone in your household travelled to a Covid-19 outbreak in the last 14 days?
Yes
No
Have you or anyone else in your household travelled internationally and/or been asked to self isolate for any other reason?
Yes
No
Have you or anyone else in your household travelled outside of Saskatchewan in the last 14 days?
Yes
No
Signature
Submit
Should be Empty: