Covid 19 Health Check
COVID-19 Questionnaire and Attestation
I attest that I am not experiencing any symptoms of illness such as a fever, cough, difficulty breathing, shortness of breath or malaise (severe fatigue or feeling of being generally unwell).
If I develop these symptoms, I agree that I will leave the premises immediately and immediately inform coach, manager and coordinator.
I am aware that I must follow the safety and hygiene protocols of British Columbia, the BC Public Health Agency, Field Hockey BC, and Delta Falcons.
I attest that:
• I have not travelled internationally in the past fourteen (14) days.
• I have not travelled outside the Province of British Columbia in the last fourteen (14) days.
• I have not travelled to an area highly impacted by COVID-19 within my Province in the past fourteen (14) days.
• I have not and do not believe that I have been exposed to a person with a confirmed or suspected case of COVID-19.
I attest that:
• I have not been diagnosed with COVID-19
• I have been diagnosed with COVID-19 and been cleared as noncontagious by provincial or local public health authorities (confirmation from a medical practitioner will be required and maintained in a confidential file by the organization) I acknowledge and agree that I will follow recommended guidelines, laws and protocols of British Columbia, the BC Public Health Agency, Field Hockey BC, and Delta Falcons in order to reduce the spread of COVID-19.
I acknowledge that the foregoing statements are true.