Lightning Athletics - COVID-19 Practice Questionnaire
This form should be completed daily for attending practice. If you do not complete and return this form prior to practice your athlete may need to sit out until the form in completed.
Athlete Name *
Parent/Guardian Name *
Phone Number *
Email Address *
1. In the past 14 days, have you or your athlete traveled outside of your hometown to any foreign country or area within the U.S. with a CDC Level 3 travel notice or similar State notice? A Level 3 travel notice is a "widespread ongoing transmission with OR without restrictions on entry to the United States." --> https://www.cdc.gov/coronavirus/2019-ncov/travelers/map-and-travel-notices.html * *
2. In the past 14 days, have you or your athlete been in close contact with someone (family, friend, or coworker) who returned from (a) any foreign country or (b) an area within the US with a CDC Level 3 travel notice or similar State notice? *
3. In the past 14 days, have you or your athlete been in close contact (within six feet) of a person with possible Coronavirus Infection? *
4. In the past 14 days, have you or your athlete tested positive for or been infected with Coronavirus (COVID-19)? *
5. Do you or your athlete have (or have you had in the past 14 days) any of the following symptoms: Respiratory illness, fever, cough, headache, sore throat, breathing difficulties, loss of sense of smell, unusual fatigue, body aches, or loss of taste? *
6. I acknowledge and understand there is an increased risk that COVID-19 can be transmitted in any place of public accommodation, including Lightning Athletics, who seeks to protect its staff, coaches, athletes, family members and volunteers who attend practices. By entering the team practice area I agree to assume these risks, and further agree that these risks are covered by the Parent Waiver I previously signed. As a precondition of attending team practice, I have confirmed that my answers to this questionnaire are complete, true and accurate. *
7. A mask must be worn at all times by a parent/guardian and non-athlete siblings while on our premises. *
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