Taking Out COVID-19 - CYCA's Response To COVID-19 Screening Form
All participants must have a parent/guardian over the age of 18 fill out and submit this form prior to participating in CYCA Sunday League. If a participant answers "YES" to any question, than they will not be allowed to come to practice and should self-isolate immediately as per Alberta's Public Health Orders (https://www.alberta.ca/covid-19-orders-and-legislation.aspx). A separate form is required to be submitted for each individual participant.

Please contact curl@cyca.ca with any comments, questions or concerns.

Thank you for helping us provide exceptional and safe junior curling experiences!

THE FOLLOWING FORMS NEED TO BE COMPLETED ON THE DAY OF SUNDAY LEAGUE CURLING EVERY SINGLE TIME:

CYCA Daily Health Screening Form (This Form): https://docs.google.com/forms/d/e/1FAIpQLSfg420qyv53B8LjIVxIyeTytvAx4eL0JESj4wZ74RzjHB5pjw/viewform
Airdrie Daily Health Screening Form: https://www.airdriecurlingclub.ca/covid-19-alberta-health-daily-checklist/

THE FOLLOWING FORMS NEED TO BE COMPLETED ONCE ONLY ONCE PRIOR TO ENTERING THE AIRDRIE CURLING CLUB FOR THE FIRST TIME:

Airdrie COVID-19 Declaration (one completed for every individual entering the club): https://www.airdriecurlingclub.ca/covid-19-declaration-agreement-and-waiver/
Airdrie Participant Informed Consent (one completed for every Sunday League curler): https://www.airdriecurlingclub.ca/informed-consent-and-assumption-of-risk-agreement/
Participant Full Name *
Full Names for the Family Member(s) that are Entering the Curling Club with the Participant
As per Curling Alberta's Return to Play Guidelines, we are recommending only one parent/guardian and one coach enters the club per team. We're collecting this information for contact tracing purposes. Parents/guardians of all participants must be reachable by phone for immediate pickup for the duration of the game(s).
Contact Phone Number for those Identified Above to be Entering the Facility
Collected for contact tracing purposes.
Does the participant, or anyone in their household, have symptoms of COVID-19? *
Including a fever greater than 38°C; cough; shortness of breath; difficulty breathing; sore throat; fatigue; nausea; vomiting; diarrhea; headache; feeling unwell; unexplained loss of appetite; smell or taste; muscle or joint aches; pink eye or runny nose
Has the participant, or anyone in their household, been outside of Canada in the last 14 days? *
Has the participant, or anyone in their household, been in unprotected close contact with a probable or confirmed case of COVID-19 within the last 14 days? *
Does the participant and everyone entering the Curling Club have a mask or face covering? *
Please note that the CYCA expects that everyone wears a mask or face covering when they are in the lobby of the curling rink and STRONGLY RECOMMENDS that a mask is worn at all times except for while sweeping.
Thanks so much for filling out this form and doing your part to help us Take Out COVID-19. We really appreciate it!
A REMINDER THAT IF THE PARTICIPANT ANSWERED YES TO ANY OF THE ABOVE QUESTIONS, THEY WILL UNFORTUNATELY NOT BE ABLE TO PARTICIPATE IN CYCA AND MUST SELF-ISOLATE IMMEDIATELY AS PER ALBERTA PUBLIC HEALTH ORDERS.
https://www.alberta.ca/covid-19-orders-and-legislation.aspx
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy