Harding University Volleyball Camp COVID-19 Screening Form
Please complete this form within 48 hrs of the clinic. If you check "yes" to any box, please stay home. Please fill out this form prior to each clinic you attend. Thank you!
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Email *
Full Name
Cell Phone Number
Have you been within 6 feet of a person with a lab-confirmed case of COVID-19 for at least 5 minutes, or had direct contact with their mucus or saliva, in the past 14 days? *
In the last 48 hours, have you had any of the following NEW symptoms? Fever of 100+, cough, trouble breathing or shortness of breath, muscle aches, sore throat, loss of smell or taste, nausea, vomiting, diarrhea, or headache *
Have you been asked by a medical or school official to stay home from school due to a close contact quarantine? *
I acknowledge that volleyball is considered a "close contact" sport and there is potential for the spread of COVID-19. I agree to take full responsibility and liability in the event of contracting COVID-19 through participation in volleyball.
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If you answered "Yes" to any of these questions, please stay home. Thank you!
A copy of your responses will be emailed to the address you provided.
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