Between the Lines Sports Campus Screening Form
As per Government of Ontario guidelines and in the interest of keeping all of our clients safe, this form must be completed prior to entry of the facility by each individual client. Thank you!

Please note that failure to answer all questions below honestly may lead to your removal from your program/the facility without refund.
Name *
Phone Number *
Are you currently experiencing any of these symptoms? *
Required
In the last 14 days, have you travelled outside of Canada? *
In the last 14 days, have you had close contact with anyone who currently has COVID-19? *
Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? *
In the last 14 days, have you received a COVID Alert exposure notification on your phone? *
Submit
Never submit passwords through Google Forms.
This form was created inside of Between the Lines Sports Campus. Report Abuse