COVID-19 Youth Program Screening
*Please fill out a COVID-19 Screening for EACH individual child enrolled in a program.
In a continues effort to make CAC a safe environment, all participants must complete a health screening before/upon arriving at the club.
Our commitment to keeping the young people we serve safe is always our number one priority. All COVID-19 related concerns should be directed to General Manager Josh Smith,
, or Youth Sports and Fitness Director Matt Soucy,
Today or in the past 24 hours, have you or any household member had any of the following symptoms?
Fever (temperature of 100.0°F or above) or felt feverish?
Stomach Issues (Nausea, Diarrhea, Vomiting)?
New Loss of Taste/Smell?
New Muscle Aches?
Runny Nose or Congestion?*
None of the Above
In the past 14 days, has your child been identified as having had close contact with a person known to be infected with the novel coronavirus (COVID-19)?
In the past 14 days, has your child been diagnosed with the novel coronavirus (COVID-19)?
I understand by submitting this form I attest that the answers above are true.
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This form was created inside of Cambridge Athletic Club.