WSLL Pre Practice/Game Covid Health Check
Fill out before each practice or game.  Must be completed before player or coach is able to enter the field of play.  Answers are based on on the last 48 hours:  Data only availabe to coaches and WSLL League officials
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Name of Player on Team *
Emergency Contact Number *
Within the past 48 hours, has your child experienced or are they currently experiencing any of the following: *
Yes
No
Shortness of Breath or difficulty breathing
Runny Nose/Congestion/Coughing
Nausea/Vomiting
Unexplained muscle pain or body aches
Feeling unusually week or fatigued
Headache or sore throat
Sore throat
Measured temperature of 99.5 degrees Fahrenheit or above
Known contact with person who is lab-confirmed to have Covid-19 (Contact is defined by CDC as within 6 feet for longer than 15 minutes)
Coach Name *
I verify that I am the parent or guardian of the player listed above and am answering the following questions on their behalf. My full name is: *
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