• COMPLETION OF THIS ENTRY IS MANDATORY FOR EACH AND EVERY SESSION

    By completing this Contract Tracing/Attendance entry I agree that the player, myself and all other spectators have completed the covid-19 symptom checklist below and have answered no to all questions.
  • Click the + button to add additional rows as needed.
    First NameLast Name 
  • Date Format: MM slash DD slash YYYY
  • :
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  • Name of Soccer Field or Park
  • "I agree that the named player and named spectators have answered no to all symptoms on the checklist below.”

COVID-19 SYMPTOMS CHECKLIST

PLAYERS/COACHES/STAFF MUST COMPLETE THIS SHEET PRIOR TO ATTENDING EVERY TRAINING SESSION

ANYONE who answers YES to ANY questions CANNOT attend

This player’s parents MUST notify BCSC that they answered YES on the checklist at bcsc@bellnet.ca or 519-759-6963 and begin their fourteen (14) day pause from soccer. BCSC will notify the player and their family as to when they can return.

MUST BE SUBMITTED AT THE START OF TRAINING TO COACH.

  1. DO YOU HAVE ANY OF THE FOLLOWING SYMPTOMS?
    • a. Fever (greater than 38.0° C)?
    • b. Cough?
    • c. Shortness of breath/difficulty breathing?
    • d. Sore throat?
    • e. Runny nose?
  2. Has anyone in your household experienced the above symptoms in the last 14 days?
  3. Have you or anyone in your household travelled outside of Canada in the last 14 days?
  4. Have you or anyone in your household been in contact in the last 14 days with someone who is being investigated as a suspected case of Covid-19?
  5. Are you currently being investigated as a suspected case of Covid-19?
  6. Have you tested positive for Covid-19 in the last 10 days?

If an individual answers YES to any of the above questions, they are not permitted to participate in any in-person soccer activity for a minimum of 14 days.