Unite the North COVID-19 Reporting
COVID-19 Reporting Form
Email address *
Player Name (First and Last) *
Player's Team *
Player Birth Year *
Nature of Report *
Required
Person Affected (please specify player or family member and relation to the player) *
IF REPORTING CLOSE CONTACT: When were you informed of close contact with a person(s) who tested positive for COVID-19?
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IF REPORTING CLOSE CONTACT: Is the player showing any symptoms related to COVID-19?
When did the symptoms begin?
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DD
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YYYY
What is the last date the player was at training or other team event?
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YYYY
When was the COVID test taken?
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DD
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YYYY
When did you receive the COVID test results?
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YYYY
By checking this box, I acknowledge that I will not be allowed to return to CRU/NLS soccer (practice, games, and other team events) until at least 14 calendar days after notice of contact/exposure to COVID-19. After the 14 calendar day period, I will be notified by CRU/NLS Soccer Club when I am cleared to return to team soccer events. *
Required
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