For all Students, please complete this form EACH DAY you are scheduled for practice or meets. If this form is not on file EACH DAY, you are not eligibile for practice or meets and should not show up at school.

Last Name: *

First Name: *

Grade: *

Fever: *

No

Yes

Cough: *

No

Yes

Sore Throat: *

No

Yes

Shortness of Breath: *

No

Yes

Close Contact with Someone with Covid19: *

No

Yes

Temperature if higher than 100.3 degrees:

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