COVID-19 Daily Questionnaire (FOOTBALL)
To be completed prior to any participation in Rocket's activity
Email address *
Full Name of Player *
Level *
Required
In the past 24 hrs., has the participant had a cough? *
In the past 24 hrs., has the participant had a fever of 100.4 F or higher? *
In the past 24 hours, have you experienced vomiting, nausea, and/or diarrhea *
In the past 24 hrs., has the participant had a sore throat? *
In the past 24 hrs., has the participant had a shortness of breath? *
In the last 14 days, has the participant been in close contact with someone with confirmed Covid-19? *
In the last 14 days, has the participant travelled to an area on the NJ Travel Advisory list (NJ.gov)? *
What is the current Farhrenheit temperature of the participant? *
Enter the name of the Parent/Guardian completing this form on behalf of the minor participant OR if an adult participant (such as coach), enter your own name. I certify these answers are true to the best of my ability. *
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