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Winter Master CV-19 Monitoring Form
Symptom CV Daily Check
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* Indicates required question
Name
*
Your answer
SPORT
*
Boys Basketball
Girls Basketball
Boys Hockey
Girls Hockey
Girls Gymnastics
Boys Gymnastics
Co-Ed Swimming
Alpine Ski
Nordic Ski
Required
FEVER
*
Yes
No
Required
Nausea/Vomiting/Diarrhea
*
Yes
No
Required
Cough
*
Yes
No
Required
Sore Throat
*
Yes
No
Required
Shortness of Breath
*
Yes
No
Required
Recent Loss of Taste or Smell
*
Yes
No
Required
Close Contact with someone COVID-19 Positive
*
Yes
No
Required
Traveled Out of State within Past 2-weeks
*
Yes
No
Required
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