What is your last name? *

What is your first name? *

Are you or a family member participating at the club today experiencing any of these symptoms: fever of 100.4 or higher, dry cough, shortness of breath, or flu like symptoms? *

Have you or a family member participating at the club today been in contact with some who is Covid-19 Positive in the last 14 days? *

Have you or a family member participating at the club today traveled internationally or out of the state via public transportation (Plane, Bus, etc.) in the last 14 day? *