Mt. Pleasant/Valhalla AYSO 221 Core Player COVID-19 Health Screening Form
Pre-Participation COVID-19 Health Screening Form for Player Participation

In an effort to continue to provide a healthy and safe environment, to help prevent the spread of COVID-19, a parent/guardian of a player is requested to complete this form by 8:00 AM on Saturday, confirming that they have not experienced any COVID-19 CDC-defined symptoms.

Parents and Guardians, it is very important that you read and adhere to the protocols outlines in the Mt. Pleasant/Valhalla AYSO 221 Return to Play document. All health and safety guidelines are outlines in this document, and players/parents/guardians must be responsible for adhering to the social distancing, face covering, and other guidelines that have been established.

Parents/Guardians are required to monitor their child's health and are not to attend any sessions or come to practices or games if they answer yes to any of the questions below. Parents must immediately contact Chris Mattoni and John Vulcano if their child develops any COVID-19 CDC-defined symptoms while at a practice or game.
Email *
Player First Name *
Player Last Name *
Parent/Guardian Cell Phone Number *
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