Burke Athletic Club
PRE-TRAINING SCREENING QUESTIONNAIRE

BAC is a community club and it is everyone’s responsibility to complete this questionnaire honestly and accurately for the health and safety of all.

Every player, coach, and team manager must answer honestly the following pre-training questions before every team function. BAC will prohibit any player or coach from attending BAC event, if their temperature is 100.4 or higher OR if they have answered YES to the questions listed below.
Email address *
Player Name *
Have you had any close contact with a sick individual or anyone with a confirmed case of COVID-19? *
If you answered YES to the previous question, have you quarantined for 14 days AND are you asymptomatic? *
Have you had a documented case of COVID-19 in the last 14 days? *
Are you currently demonstrating or suffering from any ill symptoms (fever, cough, shortness of breath, sore throat, muscle ache, fatigue, etc)? *
Gender *
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