Goalie COVID Screening form

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This form is to be filled out prior to camp starting; however if you and your daughter have been in contact with others that have travelled or covid tested people who are awaiting swab results during the course of this camp we ask that you immediately self-identify and speak with the Vice-President and not attend the camp.

Email *

Name of the Participant *

Have you or anyone traveled outside of Canada in the last 14 days *

Yes

Have you, or has anyone in your household been in contact in the last 14 days with someone who is being investigated or who has a confirmed case for COVID-19? *

Yes

Are you currently being investigated as a suspect case of COVID-19? *

Yes

Have you tested positive for COVID-19 in the past 10 days? *

Yes

Please sign below of confirmation of the information below *

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