Foothills Soccer Club- Staff, Coach & Player COVID-19 Pre-Screening Generation Phase - BU16-20
This form is required to be completed by all members prior to participating. Form must be filled out on the day of training.
First and Last Name
BU17Foothills FC 17
BU17Foothills FC 16
BU17Foothills 17 Prospects
CUSAFoothills FC Men's Division 1
Foothills U17 Generation
Foothills U23 USL2
Foothills Men's Premier
Your phone number
Select the Training Location you are at:
Lake Placid Fields
Deer Ridge Fields
Robert Warren Fields
Don Bosco Field
EP Scarlett Fields
Enter your Practice Start Time
Who drove you to soccer today?
Who is picking you up from soccer today?
Do you have any of the below symptoms?
Check all that apply.
Fever (Greater than 38.0c)
Shortness of Breath
Has anyone in your household experienced any of the above symptoms in the last 14 days?
Have you, or anyone in your household traveled outside of Canada in the last 14 days?
Have you, or anyone in your household been in contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19?
Are you currently being investigated as a suspect case of COVID-19
Have you tested positive for COVID-19 within the last 10 days?
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