Covid-19 Self Assessment Form (Oakville Minor Baseball)
Team Finder
Contact
Search
Login
Contact
Search
Home
Team Finder
Organization Menu
Home
Front Office
About Us
Contact Us
Executive and Board of Directors
OMBA Constitution (Approved November 17, 2020)
Links
House League
House League
2021 House League Registration Form
2021 House League Coaching Application
2021 House League Rates
2021 Days of Play
Frequently Asked Questions
House League Rules
Rep Program
Rep Program
Covid-19 Self Assessment Form
2021 Rep Coaches
Rep Coach Evaluation Form
Mission Statement
Representative Baseball
Rep Manual
Oakville A's Rep Manual
Coach Certification
The Dugout
The Dugout
Dugout Terms of Use
Photo Gallery
Sponsorship
House League Sponsorship
League Sponsorship
Sponsorship Application
Volunteering
High School Student Volunteer Sign-up Form
Baseball Oakville Committee Sign Up
Umpires
Umpires
General Information
Being an Umpire
2021 Clinic Information
Payment Review
Ejections
FAQ
Getting Assignments
Rates
Open Field Bookings
Park Locations
History
Accomplishments List
Alumni
In the News
Organization Home
Covid-19 Self Assessment Form
Sitemap
Print
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
*
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
Title and navigation
Title and navigation
<<
<
April 2021
>
<<
April 2021
S
M
T
W
T
F
S
14
28
29
30
31
1
2
3
15
4
5
6
7
8
9
10
16
11
12
13
14
15
16
17
17
18
19
20
21
22
23
24
18
25
26
27
28
29
30
1
19
2
3
4
5
6
7
8
Open the time view popup.
Time picker
Time Picker
12:00 AM
1:00 AM
2:00 AM
3:00 AM
4:00 AM
5:00 AM
6:00 AM
7:00 AM
8:00 AM
9:00 AM
10:00 AM
11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
4:00 PM
5:00 PM
6:00 PM
7:00 PM
8:00 PM
9:00 PM
10:00 PM
11:00 PM
Location of Game/Practice/Event
*
Select One...
West Oak Trails
Glen Abbey Small
River Oaks
Oakville Park
The Dugout
Team/Coach
*
Select One...
Minor Rookieball Manish Pathak
Minor Rookieball Derek Smith
Major Rookeball Sean Martin
Minor Mosquito Myron Bien
Minor Mosquito Brandon Newman
Minor Mosquito Jeff Dinham
Major Mosquito Justin Le Dressay
Major Mosquito Jason Sinclair
Major Mosquito Jason Smith
Minor Peewee Alan Mangaroo
Minor Peewee Jamie Logan
Minor Peewee Arden Semper
Major Peewee Nathan Brown
Major Peewee Ken Le
Major Peewee Bryan Hune
Minor Bantam Gregg Zaun
Minor Bantam Greg Young
Minor Bantam Chris Cooney
Major Bantam Sean Seguin
Major Bantam Jeremy Mason
Major Bantam Rob Merwin
Minor Midget Kyle Liberto
Minor Midget Michael Dombek
Major Midget Gregg Zaun
Major Midget Colin Brocklebank
Major Midget Kanti Dinda
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
Human Validation
Check The Box
*
Human Validation Failed, Please Try Again