COVID-19 Screening
Each skating class a skater comes to, they will need to fill out the form prior to entering the rink.
Email address *
Do you or your child (or another accompanying your child to the skating lesson) or anyone you have been in contact with have any of the following symptoms? Check all that apply. *
Required
Have you or others attended today’s skating session traveled outside of our local area or outside of the US within the past 14 days? *
Have you, your child, or others attending today’s skating session, or anyone you have recently been in contact with tested positive for or been diagnosed as having COVID-19 or any other communicable disease? *
I understand that if the answer to any of these questions is yes, I may be asked to reschedule this skating practice. *
MM
/
DD
/
YYYY
Skaters Name *
Parents Name *
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy