Taiso Recreation Self Assessment
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1. Today's date: *
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2. Athlete's First and Last Name: *
3. ONLY IF PARTICIPATING IN CLASS- Parent/Guardian's First and Last Name in Parent & Tot and Parent & Kinder Classes:
4. Class time:
5. Do you have any of the following symptoms: -Fever and/or chills -Muscle or joint aches and pains not related to overuse or exercise -Cough, shortness of breath or difficulty breathing not related to a chronic condition (i.e. asthma) - Dizziness -Sore throat -Loss of sense of smell or taste -Unusual headache -Diarrhea, vomiting or nausea -Loss of appetite (or difficulty feeding for children) -Conjunctivitis -Nasal congestion or a runny nose not related to allergies - YOU MUST BE 48 HOURS SYMPTOM FREE TO ATTEND TRAINING *
6. Have you been in direct contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19 and/or have been told to isolate because of a Covid-19 contact? *
7. Has anyone in your household been in direct contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19? If yes, you may still attend IF you are following all protocol given to you by the SHA, which includes the family member being isolated away from the rest of the family. *
8. Have you, or anyone in your household, in the past 14 days traveled to a community outside of Saskatoon, but within Saskatchewan? If yes, please self monitor for 14 days. *
9. Have you, or anyone in your household, traveled within Canada, outside of Saskatchewan? If yes, please self monitor for 14 days. *
10. Have you, or anyone in your household traveled internationally and/or been instructed to self-isolate for any other reason? *
Signature (parent if under 18) - By typing your name you agree the question answers are true. If you answered yes to #5, #6 or #10 you may not enter Taiso Gymnastics. *
ADDITIONAL INFORMATION
This form is in accordance with, and is subject to change based on the guidelines from Gymnastics Saskatchewan, Saskatchewan Health, Government of Saskatchewan and Taiso Gymnastics.

If you have recently developed any of the above symptoms, please call 811 or visit:
https://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019-novel-coronavirus/covid-19-self-assessment to do a self-assessment to see if you require testing.

Be sure to practice good hand hygiene (use hand sanitizer or wash hands with soap and water for at least 20 seconds) before entering and leaving the facility.

Masks must be worn when entering of exiting the building. They will remain with the athlete, and may be asked to wear them at times throughout training

You must be 48 hours symptom free, or have been given the clear with SHA by receiving a negative Covid 19 test in order to attend classes.

Our goal is to minimize the risk of illness to you, your children, your family and our staff. We thank you for your cooperation and understanding.
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