Before you enter the PCCIA, lets be safe.

In an effort to comply with State of Alabama guidelines, skaters and guardians must submit the form below each day, on the day they plan to attend a session or event. Forms must be submitted at least one hour before arrival time.

EACH PERSON ENTERING THE BUILDING MUST FILL OUT THIS COVID-19 QUESTIONNAIRE SCREENER.

Only one companion may enter the facility with a minor skater (under 18). No other companions will be permitted. Companions of minors will be allowed in the facility and must sit in designated areas.

Temperatures will be taken by the Pelham Civic Complex and Ice Arena staff upon entrance to the facility.

Face masks or coverings are strongly encouraged when in common areas, such as the lobby or banquet hall, when social distancing is not achievable. Masks are not required by athletes while training.

Today's Date *

YYYY

First and Last Name *

Email of Skater or Guardian *

Cell Phone of Participant or Companion *

Participant understands and agrees to the following: *

Participant must bring their own hand sanitizer, tissues, water bottle or energy drink. These items will not be provided.

Participant must bring their own notebook, pen, or pencil.

Participants will not be allowed to use the locker rooms. No personal items (including skates) may be stored at the Pelham Civic Complex and Ice Arena.

Participant must arrive at the facility in the attire that they plan to train in. There will be no changing of garments at the facility.

No outside food is allowed in the facility.

Participants or companion will not enter the facility if they are not feeling well.

Required

In the last 48 hours have you experienced:

Fever or chills

Any shortness of breath

Dry cough

Runny nose

Sore throat

Experienced a new loss of taste or smell

If you checked any of the above, please explain:

In the last 24 hours have you experienced vomiting or diarrhea? *

YES

Within the last 14 days have you:

Traveled to a foreign country

Been on an airplane, cruise ship, train, or public transportation

Been in contact with a person tested positive for COVID-19 or is suspected to be positive in the past 14 days?

If you checked any of the above, please explain:

I have been practicing all current CDC guidelines with respect to social distancing. *

YES

Submit

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms