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CHIMO GYMNASTICS DAILY HEALTH SCREENING
CHIMO GYMNASTICS CLUB DAILY COVID-19 SCREENING FORM
By order of the Provincial Health Authority, anyone entering the facility must must complete a daily screening.
Each athlete/participant requires a form.

This form is intended for the participants in a Chimo Gymnastics Program. If parents or guardians enter the building they must also submit this form.

If an individual experience seasonal allergies ( or other cold symptoms) they should have a doctors' note explaining their symptoms before entering the gym.

Immuno compromised (HIGH RISK) individuals should consult a medical practitioner before registering and participating in a program.
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Email *
Name of emergency contact *
Emergency contact phone number *
Name of athlete *
Group Name (Recreational or Competitive) *
Todays Date *
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