U17G - Power
All players must check fill in this form* before leaving their house for league play. Players will use this survey form to screen for symptoms. If you answer yes to ANY of the questions, go home & self-isolate. Call Telehealth or your health care provider to find out if you need a test.

If you answered NO to all of these questions, you can attend your activity.

The above questions are used to screen for COVID-19 before entry, as per direction from the Medical Officer of Health.

Once arriving at the court, please check in with one of the PYBA Executive. Even if arriving late, all participants must check in online AND with their coach before warming up or playing. *Please make sure you are filling it out for the player you are responsible for.
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What is your name? *
In the past 5 days, have you experienced fever, new onset of cough or worsening of chronic cough, new or worsening shortness of breath, new or worsening difficulty breathing, runny nose, headache or sore throat that is not related to a pre-existing illness or health condition? *
Do you have chills, muscle or joint ache, are feeling unwell, have fatigue or severe exhaustion, nausea,  loss of sense of smell or taste? *
In the past 14 days, did you return from travel outside of Canada and been told to quarantine, or did you have close contact with someone who is confirmed as having COVID-19 and been told to self-isolate by a doctor, healthcare provider, or public health unit? *
In the past 5 days have you tested positive for Covid-19? This includes a positive COVID-19 test result on a lab-based PCR test, rapid molecular test, rapid antigen test, or home-based self-testing kit. *
Do any of the following apply? You live with someone who is currently isolating because of a positive COVID-19 test. You live with someone who is currently isolating because of COVID-19 symptoms. You live with someone who is waiting for COVID-19 test results. Select “No” if you completed your isolation after testing positive on or after December 20, 2021 (using a rapid antigen, rapid molecular, or PCR test). *
Please add the name and contact number for the spectator that will be staying with the player.
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