Brownsburg Swim Club Covid-19 Symptom Screening
All questions must be answered every day for participation.
Name (Last, First) *
Swimming Group *
Have you experienced any of the following symptoms in the last 72 hours? Fever, cough, loss of taste or smell, difficulty breathing, muscle pain (not due to exercise), pro-longed headaches, vomiting, diarrhea or sore throat? *
What is your temperature today? *
Have you had close contact or cared for anyone who has tested positive for COVID-19 recently? *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy