Thunder FC Daily Screening Form
This form is to be completed prior to each training session by all attending participants. If we do not receive the completed form prior to 12:00 on the day of training you will not be allowed to train.
All questions must be answered.
Primary Phone Number
Which program are you registered in
Gender of program
Have you traveled outside the Atlantic Provinces in the past two weeks?
Have you been within two meters of someone with a confirmed case of COVID-19 in the last two weeks? * *
In the past 14 days, have you been in close contact with someone who has traveled out of the Atlantic Provinces who has a cough and/or a fever of higher than 38 C?
Do you have a fever higher than 38 C or a new cough?
Do you have any of the following symptoms? If you have any of the symptoms listed below, please stay at home.
Fever (chills, sweats)
Cough or worsening of a previous cough
Shortness of breath
Nasal congestion/runny nose
Loss of sense of smell or taste
Red, purple or bluish lesions on the feet, toes, or fingers that do not have a clear cause
None of the above
If you answered YES to any of the questions above please do not show up to training until your symptoms subside, you have observed the mandatory two-week self-isolation necessary when arriving to the Atlantic Provinces from abroad, or have gone through the 811 processes after being in contact with a known case of Covid-19. Do you understand?
A copy of your responses will be emailed to the address you provided.
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