Pop Up Tennis Kids Health Screening
Please help us keep everyone safe by completing the health screening below for each person entering the gym.
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Email *
Name of Person Entering Gym *
Do you currently have any of these symptoms? Please check all that apply. *
Have you had a positive COVID-19 test in the last 10 days? *
Have you or someone you live with been in close contact with someone who has a confirmed or suspected COVID-19 diagnosis in the past 10 days? *
Have you been mandated or advised by a government agency, physician or school to isolate or self-quarantine? *
Traveled in the past 2 weeks? Stayed home? Please choose the response that best matches your situation below. *
Please certify that the above information is true by noting the first and last name of the person completing this form. *
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