All volunteers must complete this questionnaire prior to the game or event.

Volunteer - First Name *

First Name - Title Case, e.g. Connor

Volunteer - Last Name *

Last Name - Title Case, e.g. McDavid

Phone Number *

Smartphone

Email *

Contact Email Address

Are you experiencing any symptoms of sickness? *

Yes

Have you or any family member attending the skate had close unprotected contact (face-to-face contact within 2 metres/6 feet) with someone who is ill with a cough/fever? *

Yes

Have you or anyone in your household been in close unprotected contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19? *

Yes

If you have checked any boxes indicating sick symptoms or answered YES to any of these questions, do not participate in the ice session. Go home and please use the Alberta Health Services Online Assessment Tool to determine if testing is required.

Thank you for completing this form.

South Side Athletic Club

Elite AAA/AA | U13 | U15 | U16 | U17 | U18

SSAC JFM COVID Questionnaire