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Covid-19 Questionnaire for Student-Athletes

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Covid-19 Questionnaire for Student-Athletes

To participate in workouts during the summer recess period, the parent/guardian must complete this form. This form only needs to be completed one time. 

Grade*
Answer required for "Grade"
Has your son/daughter been diagnosed with Coronavirus (COVID-19)? *
Answer required for "Has your son/daughter been diagnosed with Coronavirus (COVID-19)? "
If diagnosed with Coronavirus (COVID-19), was your son/daughter symptomatic?*
Answer required for "If diagnosed with Coronavirus (COVID-19), was your son/daughter symptomatic?"
If diagnosed with Coronavirus (COVID-19), was your son/daughter hospitalized?*
Answer required for "If diagnosed with Coronavirus (COVID-19), was your son/daughter hospitalized?"
Has any member of the student-athlete’s household been diagnosed with Coronavirus (COVID-19)?*
Answer required for "Has any member of the student-athlete’s household been diagnosed with Coronavirus (COVID-19)?"
Does your son/daughter have pre-existing medical conditions and/or are they immunocompromised (e.g., diabetes, asthma, auto-immune disorders, etc.)?*
Answer required for "Does your son/daughter have pre-existing medical conditions and/or are they immunocompromised (e.g., diabetes, asthma, auto-immune disorders, etc.)?"
PARENT/GUARDIAN: By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. *
Answer required for "PARENT/GUARDIAN: By selecting the \"I Accept\" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting \"I Accept\" you consent to be legally bound by this Agreement's terms and conditions. "