COVID-19 Daily Screening - Gymnast | Coach | Volunteer
THIS SCREENING MUST BE COMPLETED WITHIN 2 HOURS OF THE START OF EACH PRACTICE/CLASS BY ALL PARTICIPANTS (Gymnasts, Coaches, Volunteers)
- Please check the participant's temperature prior to coming to the studio. If you/they have any signs of fever (38 degrees or higher) please keep yourself/them home.
- A parent/guardian must complete the online COVID-19 questionnaire for participants aged 18 and under (18+ can complete their own questionnaire) prior to coming to the studio/gym. This needs to be done each time the participant plans to visit the studio/gym.
Questionnaires are time stamped when they are submitted and the time stamp must be within 2 hours of the start of the participant's registered class. Questionnaires will be held for 2 weeks (in case further investigation is required by AHS) and then deleted.
Which Class are you in?
Rec 4-5 Thursdays, 4:45pm @ Terwillegar Rec.
Rec 4-5/5-7 (A) Saturdays, 10:50am @ Terwillegar Rec.
Rec 5-7 Thursdays, 5:45pm @ Terwillegar Rec.
Rec 5-7 Saturdays (B), 11:50am @ Terwillegar Rec.
Rec 7+ Saturdays, 11:30am @ Terwillegar Rec.
FIRST & LAST Name of Participant (Gymnast, Coach or Volunteer)
Name of Parent/Guardian completing questionnaire if participant is under the age of 18 (in case AHS has tracing questions) *
Do you have any of the below symptoms? Select all that apply, selecting NONE means that you are answering NO to all symptoms *
Shortness of Breath/Difficulty Breathing
Have you or anyone in your household travelled outside of Canada in the last 14 days?
Have you, or anyone in your household been in contact in the last 14 days with someone who is being investigated or is a confirmed case of COVID-19?
Are you currently being investigated as a suspect case of COVID-19?
Have you tested positive for COVID-19 in the last 10 days?
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Elena's Rhythmic Gymnastics Club.