Covid Form

COVID-19 PRE-TRAINING SCREENING FORM

This form must be completed by a parent the day of your practice prior to arriving at the facility. Players who have not had this form completed by a parent will not be able to take part in activities.
Player Name*
First Last
Date of Scheduled Workout*
Date Format: MM slash DD slash YYYY
Time of Scheduled Workout*

: HH

MM
Type of Workout*
Is your child participating in a Complete Game activity or event (or any individual with whom they share a domicile residence) currently ill or experiencing flu-like symptoms?*
Has anyone in the home been diagnosed with or presumed to have COVID-19 within the past 14 days?*
Has the participant traveled internationally or on a cruise within the past 14 days?*
Has the participant returned from any U.S. state or territory beyond the immediate region (New York, Connecticut, Pennsylvania, and Delaware)?*
Has the participant been self-quarantined or self-monitoring for COVID-19 within the past 14 days?*
Has the participant been exposed to a person who has tested positive for COVID-19 within 48 hours of that person testing positive?*
Has the participant secured a negative COVID-19 test result since learning of their exposure?*
Temperature recorded at home prior to coming to facility:*
Name of person taking temperature at home:*
Relationship to the player:*
All players who qualify to train based on the above answers will have their temperature checked upon arriving to the facility or event. The player will also apply hand sanitizer from one of the hand sanitizer stations. Masks are required during check-in and upon exiting then facility or event.

Facility

Complete Game Training
260 West Crescent Ave # 9
Allendale, NJ 07401

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info@completegametraining.com
(201) 785-7856

Covid Form

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