Camden Midstate Lacrosse Covid Screening Form
Parent Name
Player Name
Child's Age Group (Team)
Contact Phone Number
Contact email address
Are you or your child presently ill?
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Have you or your child had any illness in the last 14 days, to include, fever, coughing, shortness of breath, or other flu-like symptoms?
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Have you or your child been instructed by a healthcare professional to self quarantine for 14 days?
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Have you or your child travelled out of the country in the last 14 days?
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Have you or your child been in contact with anyone who has tested positive for Covid-19?
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Is your child's temperature 99.5 or below?
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