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COVID-19 Mandatory Symptom Check
Each participant (ex. manager/coach, athlete, umpire, spectator, or other volunteer) shall submit this form prior to arriving at the field before every practice/game.
All personnel shall stay home if they are diagnosed with COVID-19, if they had a known close contact, and/or if they are experiencing any signs of illness.
Date of Practice/Game
First Name of Participant
Last Name of Participant
Full Name of Parent (if completing form for child)
Division (if umpire, select the division you are umpiring)
Team Name (if applicable)
Select the Participant's Role
Has the participant listed above experienced any of the following symptoms within the last three days -- Fever or Chills; Cough; Shortness of Breath or Difficulty Breathing; Sore Throat; Fatigue; Muscle or Body Aches; Headache; Loss of Taste or Smell; Nausea, Diarrhea, or Vomiting?
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