Covid-19 Self-Assessment
Email address *
First Name *
Last Name *
Phone Number *
Have you experienced a fever of 100.4°F or greater, a new cough, new loss of taste or smell, or shortness of breath that began within in the past 10 days? *
In the past 10 days, have you tested positive for COVID-19 from a test that used a nose or throat swap or saliva (not a blood test)? [10 days measured from the day you were tested, not from the day when you got the test result] *
To the best of your knowledge, in the past 10 days have you been in close contact (within 6 ft for at least 10 mins over a 24hr period) with anyone while they had COVID-19? *
In the past 10 days, have you returned from travel to a country with a CDC level 2 or higher health alert or for which the COVID-19 risk level is designated by the CDC as "unknown" or a U.S. state or territory, where you were out of CA for 24 hours or more? *
If you answered YES to any of the above
Please stay home and do not come to your game if you answered YES (second choice) to any of the above. You are not allowed to play.
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