Lenape Regional High School District Athletic COVID-19 Questionnaire
In order for student-athletes to participate in workouts during the summer recess period, the parent/guardian must complete this form. This form only needs to be completed one time and must be submitted one week prior to the student-athlete beginning summer workouts. A separate, paper-based symptom checklist will be required to be submitted each day in which the student-athlete is participating in workouts.
Email address *
Student Athletes Name *
Enter Today’s Date *
Cell Phone # of parent *
Enter Name of the Sport *
Has your son/daughter been diagnosed with Coronavirus (COVID-19)? *
If diagnosed with Coronavirus (COVID-19), was your son/daughter symptomatic? *
If diagnosed with Coronavirus (COVID-19), was your son/daughter hospitalized? *
Has any member of the student-athlete’s household been diagnosed with Coronavirus (COVID-19)? *
Signature of Parent *
Never submit passwords through Google Forms.
This form was created inside of Lenape Regional High School District. Report Abuse