Henry Clay Athletics COVID-19 Daily Wellness Survey
The intent of this survey is to ensure that all student-athletes, coaches, and athletics staff are not unnecessarily exposed to COVID-19 while participating in Henry Clay Athletics.

A reminder of responsibilities

Parent Responsibilities:
• Ensure child is healthy and check their child’s temperature daily.
• Provide a full water bottle for each training.
• Carpooling with other teammates is prohibited.
• Adhere to social distance requirements based on state and local health guidelines. Entering the practice area or assisting the coach/director with equipment before or after training is prohibited.
• Wash child’s clothing after every training session.
• Sanitize all equipment/instruments (e.g. cleats, ball, etc.) before and after
every training.
• Notify the coach/director immediately if your child becomes ill for any reason.
• Be sure your child has necessary sanitizer with them at all times.

Player Responsibilities:
• Temperature should be taken daily.
• Wash hands thoroughly before and after training.
• Bring own water bottle to every practice.
• Bring hand sanitizer to every training for personal use.
• Wear mask before and immediately after all training.
• Do not touch or share anyone else’s equipment, water, snack or bag.
• Practice social distancing by placing bags and equipment at least 6 feet apart.
• Wash and sanitize all equipment before and after every training.
• Refrain from group celebrations, including high fives, hugs, handshakes etc.

First Name *
Last Name *
Phone Number *
Sport *
COVID-19 patients have presented with a wide range of symptoms ranging from mild to severe. Symptoms may appear 2 - 14 days after exposure to the virus.
People with these symptoms may have COVID-19:
Fever over 100.4
New or worsening Cough
Muscle pain/aches
Shortness of breath or difficulty breathing
Fatigue
New headache
Loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
Are you experiencing any of the above symptoms related to COVID-19 that are new and not related to seasonal allergies OR to your knowledge have you been exposed to someone with the COVID-19 virus? *
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