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Covid - 19 Screening Form
*
Indicates required field
Parent Name:
*
First
Last
Athlete Name:
*
Phone Number
*
Have you been in contact with a confirmed case of Covid-19 within the last 14 days?
*
Yes
No
Has anyone in your household tested positive for Covid-19 within the last 2 weeks?
*
Yes
No
Have you been contacted by the HSE contact tracing team?
*
Yes
No
Have you been practicing social distancing?
*
Yes
No
Please tick below if you have any of the following symptoms:
*
Persistent Dry Cough
Fever above 38 degrees
Fatigue
Sore Throat
Loss of taste or smell
Difficulty Breathing
A combination of the above
Is there any issues we should be aware of?
*
Submit
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Home
About Us
Club Wear
Ask a Question
News & Events
Classes
Cheerleading
Gymnastics
NINJA WARRIOR
Schedule and Roster
Trial Sessions
Camps/ Clinics 2024 / 2025
Parent Portal