COVID SCREENING CHECK

Please fill out the following COVID declaration form in order to participate in our activity. Submissions are valid up to 24 hours prior to the activity.
Are you experiencing fever or chills?
Cough (more than usual if chronic cough) including croup (barking cough, making a whistling noise when breathing) Not related to other known causes or conditions (e.g., asthma, reactive airway
Shortness of breath (dyspnea, out of breath, unable to breathe deeply, wheeze, that is worse than usual if chronically short of breath) Not related to other known causes or conditions (e.g., asthma)
Decrease or loss of smell or taste (new olfactory or taste disorder) Not related to other known causes or conditions (e.g., nasal polyps, allergies, neurological disorders)
Sore throat (painful swallowing or difficulty swallowing) Not related to other known causes or conditions (e.g., post nasal drip, gastroesophageal reflux)
Stuffy nose and/or runny nose (nasal congestion and/or rhinorrhea) Not related to other known causes or conditions (e.g., seasonal allergies, returning inside from the cold, chronic sinusitis unchanged from baseline, reactive airways)
Headache that is new and persistent, unusual, unexplained, or long-lasting Not related to other known causes or conditions (e.g., tension-type headaches, chronic migraines)
Nausea, vomiting and/or diarrhea Not related to other known causes or conditions
Fatigue, lethargy, muscle aches or malaise (general feeling of being unwell, lack of energy, extreme tiredness, poor feeding in infants) that is unusual or unexplained Not related to other known causes or conditions (e.g., depression, insomnia, thyroid dysfunction, anemia)
Have you been in close contact of someone who is confirmed as having COVID-19 by your local public health unit (or from the COVID Alert app if they have their own phone)?

If you answered “YES” to any of the symptoms included in the questions.  PLEASE STAY HOME