Camp Participant COVID-19 Screening Questionnaire
The safety of our players, participants and staff is our overriding priority. As the coronavirus (COVID-19) pandemic continues, we are monitoring the situation closely and following the guidance from the Centers for Disease Control and Prevention and local health authorities. In order to prevent the spread of the coronavirus and reduce the potential risk of exposure to our players, participants and staff, we are asking everyone to complete and submit this questionnaire prior to the start of Camp everyday.

Please do not enter the arena until your response is complete

Please respond to each of the following questions truthfully and to the best of your ability. Your
participation is important to help us take precautionary measures to protect our players, participants and staff.

By submitting this form you are certifying that the responses provided above are true and accurate to the best of your knowledge
Player First & Last Name *
Participant Birthyear *
Parent First & Last Name *
Parent Email *
Parent Phone Number *
Is your camp participant currently experiencing, or have experienced in the past 14 days, any of the following symptoms? (Please take temperature before you answer this question.) *
Required
In the past 14 days, has your camp participant been in close proximity to anyone who was experiencing any of the above symptoms or has experienced any of the above symptoms since your contact? *
In the past 14 days, have you been in close proximity to anyone who has tested positive for COVID-19? *
By submitting this form you are certifying that the responses provided above are true and accurate to the best of your knowledge and understand that the safety and health of all participants, their families, and staff are relying on me *
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