2.25 USA Hockey Arena Health Check
For the safety of all participants and spectators, and to allow hockey and skating at USA Hockey Arena, USA Hockey requires that a Health Check form be completed for each person entering the Arena.
* Required
Please Check Box:
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Participant
Spectator
Required
Name (Participant)
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Your answer
Name (Spectator)
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Your answer
Group/Team
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Your answer
Scheduled Ice Date
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Your answer
Scheduled Ice Time
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Your answer
Email
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Your answer
Cell Phone #
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Your answer
Since your last visit to USA Hockey Arena, have you experienced any of the following? Please check all that apply.
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A fever (100.4 degree F or higher) or a sense of having a fever
A new cough or shortness of breath that you cannot attribute to another health condition
A sore throat that you cannot attribute to another health condition
A runny nose that you cannot attribute to another health condition
Head or body aches that you cannot attribute to another health condition
Nausea, vomiting or diarrhea that you cannot attribute to another health condition
Loss of taste or smell that you cannot attribute to another health condition
Have had contact with someone with COVID-19 in the last 14 days?
None of the above
Required
Please read the following and check Yes below: As a condition of entry into USA Hockey Arena, I agree to follow all USA Hockey Arena requirements for participating or attending events in the Arena, which include the requirement to wear a mask in all areas, social distancing, entry locations, parking, locker room usage, etc. Your contact information may be used contact tracing and other Arena communications.
*
Yes
Required
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