Foothills Soccer Club- Staff, Coach & Player COVID-19 Pre-Screening Development Phase - BU13-15
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 *
First and Last Name *
Team Name *
Your phone number *
FORMAT: (XXX)-XXX-XXXX
Select the Training Location you are at: *
Enter your Practice Start Time *
Time
:
Who drove you to soccer today? *
Who is picking you up from soccer today? *
Do you have any of the below symptoms? *
Check all that apply.
Required
Has anyone in your household experienced any of the above symptoms in the last 14 days? *
Has your child traveled outside of Canada in the last 14 days? *
Have you, or anyone in your household been in contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19? *
Are you currently being investigated as a suspect case of COVID-19 *
Have you tested positive for COVID-19 within the last 10 days? *
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