Foothills Soccer Club- Staff, Coach & Player COVID-19 Pre-Screening Recreation Phase
This form is required to be completed by all members prior to participating. Form must be filled out on the day of training.
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Email *
Player: First and Last Name *
Team Name *
Your phone number
FORMAT: (XXX)-XXX-XXXX
Select the Training Location you are at:
Clear selection
Enter your Practice Start Time
Time
:
Who drove you to soccer today? *
Who is picking you up from soccer today? *
Has the child traveled outside Canada in the last 14 days?
Clear selection
Has the child had close contact with a positive case of COVID-19 in the last 14 days? (face to face contact within 2 meters for 15 minutes or longer, or direct physical contact such as hugging)
Clear selection
Does the child have any new-onset (or worsening) of the following symptoms? *
Check all that apply.
Required
Have you traveled outside of Canada in the last 14 days? *
Are you currently being investigated as a suspect case of COVID-19 *
Have you tested positive for COVID-19 within the last 10 days? *
Submit
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