Hockey Hut COVID-19 Screening
This form must be completed prior to and each time you plan to attend camps or lessons (or observe) at Hockey Hut
Email *
Player / Parent / Observer Name *
Practice Date *
MM
/
DD
/
YYYY
Have you tested positive for COVID-19 in the past 14 days? *
Have you knowingly been in close contact in the past 14 days with anyone who has tested positive for COVID-19 or who has had symptoms of COVID-19? *
Have you traveled to any of the states on the NYS Quarantine list in the past 14 days? *
Have you had any of these symptoms in the last 48 hours? (select all that apply) *
Required
If you indicated yes to questions 1-3 you cannot return to the rink until the 14 day quarantine period has ended. If you have any symptoms listed in question 4, do not attend practice until cleared by a physician.
Submit
Never submit passwords through Google Forms.
This form was created inside of M is Good. Report Abuse