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Breakaway Temperature and Health Declaration Form
Temperature declarations are recorded according to submission time.
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Name *
Temperature *
Sport *
Location of activity *
By Submitting, you declare that: You have not had close contact with a confirmed COVID-19 case in the past 14 days. You are not currently under a quarantine order or stay home notice. You do not have any fever or flu like symptoms. You agree to the collection.use of your information for COVID-19 contact tracing. *Not applicable if you are seeking treatment at a medical facility. #not applicable to COVID-19 frontline workers. *
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