ILLNESS / COVID-19 Self-Screening
Required each morning & before participation in team activities.
Current Date:
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Year
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Month
Day
Name of Athlete
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First Name
Last Name
Phone # we can reach you
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Please enter a valid phone number.
Email to receive a copy of this form.
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example@example.com
Your Room #
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If you have any of the following symptoms, notify camp coaches immediately.
Check any of the symptoms you are displaying today:
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severe difficulty breathing (e.g., struggling for each breath, speaking in single words)
severe chest pain
having a very hard time waking up
feeling confused
lost consciousness
fever or chills
runny or stuffy nose
sore throat
cough
difficulty breathing or shortness of breath
nausea or diarrhea
loss or altered sense of taste or smell
sneezing
temperature equal to or more than 38°C
fatigue or weakness
muscle or body aches
headache
abdominal pain, diarrhea and vomiting
feeling very unwell
No Symptoms
To confirm if a covid-19 test is required, the symptomatic participant must complete the Self-Assessment Tool which is available via this link
https://myhealth.alberta.ca/Journey/COVID-19/Pages/Assessment.aspx/
Take Photo of Rapid Test Result (Required: Mar 15,18,21,24,27,30, Apr 3,6,9,12,15,18,21)
Take steps to protect yourself and others.
We encourage you to take the following everyday actions to prevent respiratory illness:
Stay home when feeling sick.
If possible, avoid close contact with people who are sick.
Wash hands frequently with soap and warm water for at least 20 seconds or use alcohol-based hand sanitizer.
Cover your cough.
Avoid touching eyes, nose, or mouth with unwashed hands.
Clean and disinfect frequently touched surfaces and items at home, especially when someone in your home is sick.
Using a well-fitting, high-quality mask is encouraged, especially in crowded indoor settings. Wearing a mask can help reduce your risk of becoming sick and help protect others from being exposed.
All participants (athlete or coach) must sign.
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Submit
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