573-219-1840 Como.Supreme@gmail.com

COvid Symptoms Survey

In order to keep you and your family safe, please fill out this survey prior to any tournaments or meets.

Name of Athlete(Required)
Have you had close contact with someone diagnosed with COVID-19 in the past 5 days?(Required)
Have you experienced a fever in the past 5 days?(Required)
Have you had a cough in the past 5 days?(Required)
Have you had any respiratory illness or difficulty in breathing in the past 5 days?(Required)
Have you had any loss of smell or taste in the past 5 days?(Required)
Have you been fully vaccinated?(Required)
I agree to follow the protocols listed below to ensure the health, safety and welfare of my family members as well as my teammates:(Required)
Name of Parent or Guardian(Required)
MM slash DD slash YYYY