Ashley Valley Raptor Girls COVID-19 Questionnaire
This must be completed by the parent/guardian before each team practice/training or game/competition. Coaches, players and volunteers can not participate if we don't have record of a response that day. No paper copy will be available. This must be completed prior to attending the practice or game.
Participant's Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Type of Activity
*
Hockey Practice
Hockey Game
Team Building Event (team dinner, party, etc.)
Other
Has the player, coach or volunteer had a fever within the last 24 hours? *
*
Yes
No
Has the player, coach or volunteer had any other COVID-19 symptoms within the last 24 hours? (coughing, trouble breathing, congestion, sudden change of taste or smell, sore throat, muscle aches and pains.) *
*
Yes
No
Has the player, coach, volunteer tested positive for COVID-19, or been in close contact with a person who has been within the last 14 days? *
*
Yes
No
E-Signature of parent/guardian or volunteer/coach (type your full name) confirming the answers to these questions are true.
*
Submit
Should be Empty: