Athlete Daily Screening Daily Screening Due to the Coronavirus (COVID-19) outbreak we are taking extra precautions with the care of every member to include session tracking, social distancing protocols and enhanced sanitation/disinfection procedures in accordance with the Alberta Heather Services. This form MUST be filled out EVERY DAY prior to attending training. Athlete InformationAthlete Name (First and Last)*Date of Birth* Date Format: MM slash DD slash YYYY Athlete Age Emergency Contact Information Please provide contact information to supply to Alberta Health Services for contact tracing purposes in the event there are any reported COVID-19 illnesses that may affect your athlete or others they have been in contact with. This information may not be the same emergency contact we have on file.Emergency Contact Name*Emergency Contact Phone*Email* Athletes under 18 Children should be screened every day by completing this checklist before going to the Gymnastics Club.Children may need a parent or guardian to assist them to complete this screening tool. 1. Has the child:(Choose any/all possible exposures)Traveled outside Canada in the last 14 days?*When entering or returning to Alberta from outside Canada, individuals are legally required to quarantine for 14 days unless enrolled in the Alberta COVID-19 International Border Pilot ProjectYesNoHad close contact with a case of COVID-19 in the last 14 days?*Face-to-face contact within 2 meters for 15 minutes or longer, or direct physical contact such as hugging.YesNoYou answered "Yes" to one of the above questions - The child is required to quarantine for 14 days from the last day of exposure. o If the child is participating in the Alberta COVID-19 International Border Pilot Project, they must comply with the program restrictions at all times. - If the child develops any symptoms, use the AHS Online Assessment Tool or call Health Link 811 to determine if testing is recommended. 2. Does the child have any new onset (or worsening) of the following core symptoms:Fever*Temperature of 38 degrees Celsius or higherYesNoCough*Continuous, more than usual, not related to other known causes or conditions such as asthmaYesNoShortness of breath*Continuous, out of breath, unable to breathe deeply, not related to other known causes or conditions such as asthmaYesNoLoss of sense of smell or taste*Not related to other known causes or conditions like allergies or neurological disordersYesNoYou answered "Yes" to one of the above questions - The child is to isolate for 10 days from onset of symptoms. - Use the AHS Online Assessment Tool or call Health Link 811 to determine if testing is recommended. Does the child have any new onset (or worsening) of the following other symptoms:Chills*Without fever, not related to being outside in cold weatherYesNoSore throat/painful swallowing*Not related to other known causes/conditions, such as seasonal allergies or refluxYesNoRunny nose/congestion*Not related to other known causes/conditions, such as seasonal allergies or being outside in cold weatherYesNoFeeling unwell/fatigued*Lack of energy, poor feeding in infants, not related to other known causes or conditions, such as depression, insomnia, thyroid dysfunction or sudden injuryYesNoNausea, vomiting and/or diarrhea*Not related to other known causes or conditions, such as anxiety, medication or irritable bowel syndromeYesNoUnexplained loss of appetite*Not related to other known causes or conditions, such as anxiety or medicationYesNoMuscle/joint aches*Not related to other known causes or conditions, such as arthritis or injuryYesNoHeadache*Not related to other known causes or conditions, such as tension-type headaches or chronic migrainesYesNoConjunctivitis (commonly known as pink eye)*YesNoIf the child answered “YES” to ONE symptom in question 3: - Keep your child home and monitor for 24 hours. - If their symptom is improving after 24 hours, they can return to school and activities when they feel well enough to go. Testing is not necessary. - If the symptom does not improve or worsens after 24 hours (or if additional symptoms emerge), use the AHS Online Assessment Tool or call Health Link 811 to check if testing is recommended.AHS Online Assessment Tool If the child answered “YES” to TWO OR MORE symptoms in question 3: - Keep your child home. - Use the AHS Online Assessment Tool or call Health Link 811 to determine if testing is recommended. - Your child can return to school and activities once their symptoms go away as long as it has been at least 24 hours since their symptoms started. Athletes 18 years and older If an individual answers YES to any of the questions, they are not allowed to attend or participate in any activity or program Do you have any new onset (or worsening) of any of the following symptoms: Fever*YesNoCough*YesNoShortness of Breath / Difficulty Breathing*YesNoRunny Nose*YesNoSore Throat*YesNoYou answered YES to one of the above questions. Please do not attend class or training and follow required health orders *Individuals with fever, cough, shortness of breath, runny nose, or sore throat, are required to isolate for 10 days per CMOH Order 05-2020 OR receive a negative COVID-19 test and are feeling better before returning to activities. Use the AHS Online Assessment Tool to determine if testing is recommended and the following information on isolation requirements. Do you have any new onset (or worsening) of any of the following symptoms:Chills*YesNoPainful Swallowing*YesNoNasal Congestion*YesNoFeeling unwell/Fatigued*YesNoNausea/ Vomiting/ Diarrhea*YesNoUnexplained loss of appetite*YesNoLoss of sense of taste or smell*YesNoMuscle / Joint aches*YesNoHeadache*YesNoConjunctivitis (commonly known as pink eye)*YesNoYou answered YES to one of the above symptoms. If an individual answers YES to any of the questions, they are not allowed to attend or participate in any activity or program. Has the attendee travelled outside of Canada in the last 14 days?*Individuals are legally required to quarantine for 14 days when entering or returning to Alberta from outside Canada unless exempted by the Alberta COVID-19 Boarder Testing Pilot Program.YesNoHas the attendee had close contact1 with a confirmed case of COVID-19 in the last 14 days?*Face-to-face contact within 2 meters. A health care worker in an occupational setting wearing recommended personal protective equipment is not considered to be a close contact.YesNoYou answered YES to one of the above symptoms. If an individual answers YES to any of the questions, they are not allowed to attend or participate in any activity or program. Please follow Alberta Health regulations and recommendations prior to returning to class. If the participant arrives exhibiting any of the above symptoms, staff has the right to refuse entry into the facility. If the participant develops any of the above symptoms, staff will implement their rapid response to symptomatic individuals’ policy. I understand that coaches, employees, or volunteers cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each participant.Signature