Covid-19 Self Assessment Form, A's Rep (Oakville Minor Baseball)
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COVID-19 Self Assessement
Mission Statement
Minor Rookieball Team 1
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Minor Peewee Team 3
Major Peewee Team 1
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Major Peewee Team 3
Minor Bantam Team 1
Minor Bantam Team 2
Major Bantam (BEL) Team 1
Major Bantam Team 2
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Major Midget (MEL) Team 1
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Team Websites
Minor Rookieball Team 1
Minor Rookieball Team 2
Major Rookieball Team 1
Major Rookieball Team 2
Minor Mosquito Team 1
Minor Mosquito Team 2
Major Mosquito Team 1
Major Mosquito Team 2
Major Mosquito Team 3
Minor Peewee Team 1
Minor Peewee Team 2
Minor Peewee Team 3
Major Peewee Team 1
Major Peewee Team 2
Major Peewee Team 3
Minor Bantam Team 1
Minor Bantam Team 2
Major Bantam (BEL) Team 1
Major Bantam Team 2
Minor Midget Team 1
Minor Midget Team 2
Major Midget (MEL) Team 1
Major Midget Team 2
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A's Rep
Covid-19 Self Assessment Form
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Covid-19 Self Assessment Form
Participant's Information
First Name
*
Last Name
*
Email Address (Parent/Guardian if under 18)
*
Example:
[email protected]
Your submission will be sent to this address.
Event
Date and Time of Game/Practice/Event
*
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RadDatePicker
Open the calendar popup.
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Self Assessment to be completed WITHIN 12 HOURS of game/practice
Do you have a fever?
*
Yes
No
Do you have a cough?
*
Yes
No
Do you have difficulty breathing?
*
Yes
No
Do you have a sore throat, trouble swallowing?
*
Yes
No
Do you have a runny nose?
*
Yes
No
Do you have loss of taste or smell?
*
Yes
No
Do you have nauseau, vomiting, diarrhea?
*
Yes
No
Have you been in close contact with someone who has confirmed or probable Covid-19 in the past 14 days without wearing appropriate PPE?
*
Yes
No
Have you returned from travel outside Canada in the past 14 days?
*
Yes
No
If you answered YES to any of these questions, do NOT attend the game/practice. Self isolate right away. Call Telehealth or your health care provider, to find out if you need a test
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