Thorncliffe Covid Screening

Thorncliffe Tennis Club- COVID-19 Screening Form

Members and Guests must complete this screening form on the day of their court booking and prior to entering the club.This screening form must be completed prior to every visit and by everyone who will be on the court. Failure to complete this screening form will result in losing your court booking.
Full Name *

First Name Last Name
Child's Name (enter your child's name if your child is playing at the club today)

First Name Last Name
Phone Number *

Area Code Phone Number
Are you or child coming to play at the club today ? (screening only valid for the same day you are playing at the tennis club *

YES
Do you or your child if applicable, have any of the following symptoms?: *

Cough Shortness of breath or difficulty breathing Fever or Chills Muscle or body aches Sore Throat Headache Nausea or Vomiting Diarrhea Runny Nose or Stuffy Nose Fatigue Recent loss of Taste or Smell No Symptoms
If you have checked off ANY of the symptoms above, please inform the club staff and DO NOT enter the club; follow public health guidelines regarding testing, self isolation and seek medical assistance as needed.
In the last 14 days, have you or your child if applicable been identified as a “close contact” of someone who currently has COVID-19? *

Yes No
Have you or child if applicable traveled anywhere outside of Canada in the past 14 days? *

Yes No
Is anyone you or child if applicable, live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms? *

Yes No
If you have answered "YES" to any of the questions above, and you cannot explain these symptoms by known allergies or non-infectious illnesses, then you cannot enter Thorncliffe Tennis Club for the safety of others
I certify that the information submitted in this form is true and correct to the best of my knowledge. I further understand that it is my responsibility to immediately inform Thorncliffe Tennis Club of any changes to the answers I've provided.

I understand that COVID-19 is highly contagious and poses serious health risks to myself and others. By signing this document, I hereby release and indemnify Thorncliffe Park Tennis Club, including its officers, directors, staff, and volunteers from and against all liability arising from any potential COVID-19 exposure caused to, or by, myself and/or my guests.
Signature *

Clear
Todays Date *
Should be Empty:

Thorncliffe Tennis Club- COVID-19 Screening Form