Guardian Name

Guardian Email

Athlete's Name

Is your Temperature greater than 100.3 today?
NoYes - Please stay home!

Do you or our have a cough or shortness of breath?
NoYes - Please stay home!

Do you have a sore throat, chills, muscle aches, headache?
NoYes - Please stay home!

Do you have a new loss of taste or smell, Ab pain, nausea, vomiting or diarrhea?
NoYes - Please stay home!

Have you had close contact with someone who is currently sick?
NoYes - Please stay home!

Have you been diagnosed with Covid-19 in the past 3 weeks?
NoYes - Please stay home!

Have you traveled or had close contact with anyone who has traveled internationally in the last 14 days?
NoYes - Please stay home!

Do you have any other symptoms related to Covid-19 not specifically listed above?

If you answered "Yes" to any of the Covid-19 related symptoms above, please stay home.