Connaught Skating Club - Daily Screening
Skaters, Volunteers & Coaches are required to complete this daily screening prior to participation in club programming at the Richmond Olympic Oval, Richmond Ice Centre & Minoru Arena for training.
First Name: *
Last Name:
Email: *
Phone Number: *
Facility: *
Training Pod: *
1. Do you have any of the following symptoms: fever, cough, shortness of breath or difficulty breathing?
2. Do you have at least two of these symptoms: chills, repeated shaking with chills, headache, sore throat, new loss of taste or smell?
3. Have you, or anyone in your household, returned from a trip outside the country within the last 14 days?
4. In the past 14 days, have you been in contact with someone with, or suspected to have, COVID-19?
5. In the past 14 days, have you been directed by Public Health to self-isolate?
Do any of above these questions apply to you? *
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