Covid-19 Practice Participation Daily Covid-19 Symptoms Checklist Fields marked with an * are required Practice Date * Full Name * Email * Your Participant Role * Player Coach Staff Other Age Group * U-8 U-9 U-10 U-11 U-12 U-13 U-14 U-15 U-16 U-17 U-18 Adult Title any symptoms Do you have any of the below symptoms? a. Fever (greater than 38.0 C)? b. Cough? c. Shortness of breath / difficulty breathing d. Sore throat? e. Runny nose? 2. Has anyone in your household experienced any of the above symptoms in the last 14 days? 3. Have you, or anyone in your household travelled outside of Canada in the last 14 days? 4. Have you, or anyone in your household been in contact in the last 14 days with someone who is being investigated as a suspected caseof COVID-19? 5. Are you currently being investigated as a suspected case of COVID-19? 6. Have you tested positive for COVID-19 within the last 10 days? Title warning If you answer "YES" to any of the above questions you are not permitted to participate in any in-person soccer activities for a minimum of 14 days? Any additional feedback? If you are a human seeing this field, please leave it empty.