Tecumseh SC COVID-19 Assessment
Please complete the form prior to attending your training session (each day that you train).
Participant Name (Full Name)
Team Age Group
Youth Academy (Born 2014 or Younger)
Under 7 (2013)
Under 8 (2012)
Under 9 (2011)
Under 10 (2010)
Under 11 (2009)
Under 12 (2008)
Under 13 (2007)
Under 14 (2006)
Under 15 (2005)
Under 16 (2004)
Under 17 (2003)
Under 21 (Born in 2002 or Older)
Are there any known health conditions or information about the participant that you believe Tecumseh SC should be aware of to best support the participant (If yes, please explain only if you feel comfortable. If no, please write "No").
Page 1 of 11
Never submit passwords through Google Forms.
This form was created inside of Tecumseh Soccer Club.