COVID-19 DAILY SCREENING FORM

Date of your Booking/Activity *

Do you (participant and/or supervising parent/guardian) currently have any COVID-19 related symptoms? (fever, chills, cough, difficulty breathing, sore throat, difficulty swallowing, runny nose, loss of taste/smell, pink eye/conjunctivitis, headache, muscle aches, extreme tiredness, falling down often, diarrhea, nausea, vomiting, abdominal pain or nasal congestion) *

In the last 14 days, have you (participant and/or supervising parent/guardian) been identified as a “close contact” of someone who was a confirmed or probable case of COVID-19? *

In the last 14 days, have you (participant and/or supervising parent/guardian) traveled outside of Canada, or have you had close physical contact with a person who has returned from travel outside of Canada? *

Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? This can be because of an outbreak, contact tracing, or if you have tested positive. *

In the last 14 days, have you received a COVID Alert exposure notification on your cell phone? If you already went for a test and got a negative result, select “No.” *

By agreeing, I acknowledge that all information provided submitted in this form is accurate, and I have agreed to follow the policies and procedures put in place by RTC upon entering the grounds. *

RTC Covid-19 Participant Waiver and Information WITH THE ACTION OF BOOKING A COURT, IT IS ASSUMED THAT YOU HAVE READ AND AGREED TO THE FOLLOWING ASSUMPTION OF RISK AND PROTOCOLS IN PLACE AT RTC. *