SCYHA COVID-19 Questionnaire
This questionnaire must be completed for all players every session/each day before they will be allowed on the ice. Complete this COVID-19 health questionnaire prior to practice/game at the MAC. If your skater is experiencing COVID-19 related symptoms OR had close contact with someone diagnosed with COVID-19, please contact Jenna Binsfeld immediately and we ask that you keep your skater home to protect others. Please contact Jenna if you have any COVID-19 related questions.
Jenna's contact information: (320) 492-4446 or
Email *
I am/We are a...check all that apply *
SCYHA Group *
First Name/Names *
Last Name *
Do you have any of the following COVID-19 Symptoms? (Where you can not attribute the symptom to another health condition.) *
To the best of your knowledge, have you had close contact with (been within 6 feet for at least 15 minutes) or cared for someone diagnosed with COVID-19 in the past 14 days? *
A copy of your responses will be emailed to the address you provided.
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