Shen Lacrosse COVID-19 Health Assessment
This assessment must be completed each day before arriving at fall practice. You will be asked to present the confirmation email you receive.
Email address *
Player First & Last Name *
Practice Date *
You must fill out this form within 24 hours of EVERY practice date
Experienced COVID-19 Symptoms in the past 14 Days? *
Positive COVID-19 Test in the past 14 days? *
Close contact with confirmed or suspected COVID-19 case in past 14 days? *
Have you traveled out of the area in the last 14 days? *
Is your temperature symptomatic (100.4º F or higher?) *
Parent Phone *
Parent First & Last Name *
Your name constitutes your electronic signature. By signing, you are affirming this mandatory health screening assessment and have reviewed & acknowledged the Healthy & Safety Guidelines, and agree to the following guidlines.
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