U9 N1 (Mariposa Minor Hockey)

Print U9 N1
Are you currently experiencing?
If you are currently experiencing any of the following symptoms please do not enter the facility and contact your COVID representative. • Fever? (Feeling hot to the touch, a temperature of 37.8C or higher) • Chills? • Cough that's new or worsening? (continuous, more than usual) • Barking cough, making a whistling noise when breathing (croup)? • Shortness of Breath? (out of breath, unable to breathe deeply) • Sore Throat? • Difficulty Swallowing? • Runny nose, sneezing or nasal congestion (not related to seasonal allergies or other known causes or conditions) • Lost sense of taste or smell? • Pink eye? (Conjunctivitis) • Headache that is unusual or long lasting? • Digestive issues? (nausea/vomiting, diarrhea, stomach pain) • Muscle Aches? • Extreme tiredness that is unusual? (fatigue, lack of energy) • Falling down often? • For young children and infants: Sluggish or lack of appetite?

Close Physical Contact means:
In the last 14 days, have you been in close physical contact with someone who tested positive for COVID-19? In the last 14 days, have you been in physical contact with a person who is either currently sick with a cough, fever or difficulty breathing? In the last 14 days, have you been in close physical contact with a person who has returned from outside Canada in the last 2 weeks? Have you traveled outside of Canada in the last 14 days?
  1. If any individual has answered "yes" to any of these questions, they are not permitted to  participate in any on-ice or off-ice activities.
Your Information
Please provide name for who the document is for (i.e. if player documents provide players name and provide parent/guardian info in the extra box provided)
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Human Validation
Printed from mariposaminorhockey.com on Tuesday, October 27, 2020 at 11:55 AM