Youth Lessons - St. Albert Nordic COVID-19 Checklist
If you answer yes to any of the following statements, please stay home and use the AHS Online Assessment Tool to determine if testing is recommended.
* Required
Email address
*
Your email
This form must be completed by the participant or their legal guardian prior to attending each lesson.
Participant Name (not parent)
*
Your answer
Lesson Time
Tuesday 3-4pm
Saturday 1-2pm
Saturday 2:30-3:30pm
Sunday 1-2pm
Sunday 2:30-3:30
Sunday 2:30-4:00 (Track Attack)
Clear selection
Does the person attending the activity have any of the following symptoms
Fever
Cough - new or changed
Shortness of Breath/ Difficulty Breathing – new or changed
Sore throat
Chills
Painful swallowing
Runny nose / Nasal congestion - new or changed
Feeling unwell/ Fatigued
Nausea/ Vomiting/ Diarrhea
Unexplained loss of appetite
Loss of sense of taste or smell
Muscle/ Joint aches – unexplained and unrelated to physical activity
Headache
Conjunctivitis
Have you, or anyone in your household, travelled outside of Canada in the last 14 days? If so and the individual travelled for work and is not displaying symptoms, you may select no.
*
Yes
No
Required
Have you or your children attending the program had close unprotected contact (face-to-face contact within 2 meters/ 6 feet) with someone who is ill with cough and/or fever?
Yes
No
Have you or anyone in your household been in close unprotected contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19?
*
Yes
No
Required
If you answer yes to any of the above, please stay home and use the AHS Online Assessment Tool to determine if testing is recommended.
A copy of your responses will be emailed to the address you provided.
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