Parents/Guardians
(Initial each statement below)
_______ I am aware of symptoms associated with Covid-19: fever or chills, cough, shortness of breath, difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea.
_______If my child tests positive for Covid-19, I will ensure isolation according to local health department directives.
_______If my child is exposed to a known case of Covid-19, then I will ensure quarantine (14 days) according to local health department directives.
_______If my child shows symptoms associated with Covid-19 (fever or chills, cough, shortness of breath, difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea) I will keep them home from practice.
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Parent or guardian signature
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Date