COVID-19 Questionnaire
To participate in workouts during the summer recess period, the parent/guardian must complete this form. This form only needs to be completed one time. This is a recommended template for the COVID-19 Questionnaire. Districts can determine the best means (electronic or paper) and platform (Survey Monkey, Microsoft Teams,Google Docs etc.) to administer the questionnaire.
يمكنك تسجيل الدخول إلى Google لحفظ مستوى التقدم. مزيد من المعلومات
Student athlete last name *
Student athlete first name *
Parent/Guardian Cell *
Sport *
Has your son/daughter been diagnosed with Coronavirus (COVID-19)? *
If diagnosed with Coronavirus (COVID-19), was your son/daughter symptomatic?
محو التحديد
If diagnosed with Coronavirus (COVID-19), was your son/daughter hospitalized?
محو التحديد
Has any member of the student-athlete’s household been diagnosed withCoronavirus (COVID-19)? *
Signature of Parent/Guardian *
إرسال
محو النموذج
عدم إرسال كلمات المرور عبر نماذج Google مطلقًا.
Googleالنماذج
تم إنشاء هذا النموذج داخل MCMSNJ.