JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
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.
Sign in to Google
to save your progress.
Learn more
* Required
First Name:
*
Your answer
Last Name:
*
Your answer
Email:
*
Your answer
Phone Number:
*
Your answer
Facility:
*
Choose
Richmond Olympic Oval
Richmond Ice Centre
Minoru Arena
Holiday Inn - OFF ICE
Training Pod:
*
Choose
CanSkate
Junior Academy
SSD/SSB
Bronze Pod 1
Bronze Pod 2
Bronze Pod 3
Silver Pod 1
Silver Pod 2
Silver Pod 3
Gold Pod 1
Gold Pod 2
Diamond Pod 1
Diamond Pod 2
Top Flight Pod 1
Top Flight Pod 2
Volunteer
Coach
Pairs Development Program
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?
*
Yes
No
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
