2022 WTSC Covid-19 Protocols - Daily Health Screening Questionnaire
This questionnaire must be completed by each individual prior to participation in WTSC programs.

This questionnaire must be completed separately for each individual participating in WTSC programs outside and/or entering the facility on the date. You cannot complete this questionnaire in advance and a new questionnaire must be submitted daily.

The answer to all questions must be “No” in order to participate in each on-ice activity. If you have answered “Yes” to any of these questions, you are not permitted to participate in any on-ice activities and please do not come to the rink.

Please note: This Health Screening questionnaire has been developed based on the current Ontario Ministry of Health Self-Assessment Tool.

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Email *
Name(s) of people attending ( Skater, Parent/Guardian) *
Date of Session *
1. Are you currently experiencing one or more of the symptoms below that are new or worsening? Symptoms should not be chronic or related to other known causes or conditions. *
If you answered yes to any of the screening questions please do not come to the rink. Email office@wtsc.ca with your name, session date and time you will be missing.                                                                                                                                                                                                                                                                                                 *For information on Travel Exemptions to the emergency order of the Government of Canada’s Quarantine Act, please go to: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/latesttravel-health-advice.html#a3
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