Donoma Gymnastics Screening Form
Thank you for your participation at Donoma Gymnastics. We value your business and appreciate you taking the time to fill this out. Please fill this out DAILY prior to your child attending Donoma Gymnastics . Thank you!
What level/class is your child attending?
Blue and Orange
Grade School Class
GYM: Private Lesson
Parent's Night Out
SWIM: Private Lesson
What is your child's name? Please provide first and last
Today or in the past 24 hours, has your child attending class had any of the following symptoms? If any of the below are yes, you must keep your child home. 1. Fever 2. Cough 3. Sore Throat 4. Difficulty Breathing 5. Gastrointenstianl Symptoms 6. Fatigue 7. Headache 8. New Loss of Smell/Taste? 9. New Muscle Aches 10. Any Other Signs of Illness
Does anyone in your household have a pending covid-19 test? If your answer is yes, you must keep your child home until a negative test result or the board of health certifies that your child may resume normal activities.
In the past 14 days, have you had close contact with a person known to be infected with the novel coronavirus (COVID-19)? If your answer is yes, you must keep your child home
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