KGTC | Daily COVID-19 Screening Checklist
As a participant of KGTC, we are required to have each athlete complete the following Daily Screening Checklist.
By filling in and submitting this form, I am confirming I will stay home if I am unwell, or if someone in my household is unwell, or is displaying the symptoms below.
If I answer yes to any of the following I am aware that KGTC will follow the process outlined in its safety plan and the athlete will not be permitted to train or enter the facility.
Email address *
If you are an Athlete, input your first and last name.

If you are a KGTC Staff, input your first and last name.
FIRST Name *
LAST Name *
Program Name *
Select the discipline you are participating in. If you are participating in more than one on the SAME day, select both disciplines.
Placing a check mark beside each item indicates that you are declaring yourself to NOT have those symptoms or exposures.
I do NOT have the following symptoms: *
I have NOT: *
A copy of your responses will be emailed to the address you provided.
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