Covid Screener, Team 1-white/black, U10/11 S, 2020-2021 (Milton Minor Hockey)

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This Team is part of the 2020-2021 season, which is not set as the current season.
Covid Screener
Terms and Conditions:
I acknowledge that only one (1) parent/guardian of each skater under 18 years of age is permitted in the facility as an observer. Parents/Guardians are to maintain physical distancing and much watch within each rink. Watching from the lobby is nor permitted.  
I acknowledge that I will submit this screener on the day of each scheduled session, prior to arriving at the arena.  I acknowledge that failure to do so may compromise my registration in the program.  

I acknowledge that if I or any of my family have covid-related symptoms, I will notify the MMHA communications officer at : communicationofficer@miltonwinterhawks.com and info@miltonwinterhawks.com and  my participant will not attend their session. until permitted as per Halton Public Health. 

I acknowledge that if I or any of my family test positive for covid-19, I will notify the MMHA communications officer at: communicationofficer@miltonwinterhawks.com and info@miltonwinterhawks.com and my participant will not attend their session until permitted as per Halton Public Health.

Session Info

Participant Info

Please enter participant's info here.

Parent/Guardian Info

Please enter the name of the parent/guardian who will be dropping the participant at their session or attending the session with the participant.

Terms and Conditions: Are you currently experiencing any of these issues? Call 911 if you are. You cannot participate in on-ice or off-ice activities. 

 

1.   Severe difficulty breathing (struggling for each breath, can only speak in single words)

 

2.   Severe chest pain (constant tightness or crushing sensation)

 

3.   Feeling confused or unsure of where you are

 

4.   Losing consciousness

Terms and Conditions: If you are in any of the following at risk groups, we ask that you speak with your physician prior to participating:

1.  70 years old or older.
2.  Getting  treatment  that  compromises  (weakens)  your  immune  system (for example, chemotherapy, medication for transplants, corticosteroids, TNF inhibitors)

      3.  Having a condition that compromises (weakens) your immune system (for example, diabetes, emphysema, asthma, heart condition)
    4.   Regularly going to a hospital or health care setting for a treatment (for example, dialysis, surgery, cancer treatment)

Terms and Conditions: The answer to all questions must be “No” in order to participate in any and all activity (on-ice or off-ice).

1. Are you currently experiencing any of these symptoms?

*Do you have a Fever? (Feeling hot to touch, temperature of 37.8C or higher) 
*Chills
*Cough that's new or worsening (continuous.more than usual)
*Barking cough, making a whistle noise when breathing (croup) 
*Shortness of breath (out of breath, unable to breathe deepley) 
*Sore throat
*Difficulty swallowing
*Runny nose, sneezing, or nasal congestion (not related to seasonal allergies or other known causes or conditions) 
*Lost sense of smell or taste
*Pink Eye (conjunctivitis) 
*Headache that's unusual or long lasting
*Digestive Issues (nausea/vomiting, diarrhea, stomach pain) 
*Muscle aches 
*Extreme tiredness that is unusual (fatigue, lack of energy) 
*Falling Down often
*For young children and infants: sluggishness or lack of appetite

Terms and Conditions: The answer  to all questions must be “No” in order  to participate in any and all activity (on-ice or off-ice).

For the remaining questions, close physical contact means being less than 2 metres away in the same room, workspace, or area for over 15 minutes or living in the same home

*In the last 14 days, have you been in close physical contact with someone who tested positive for COVID-19?

*In the last 14 days, have you been in close physical contact with a person who either:

*Is currently sick with a new cough, fever, or difficulty breathing;
*OR Returned from outside of Canada in the last 2 weeks?


*Have you travelled outside of Canada in the last 14 days?

 


Terms and Conditions: If an individual has answered “Yes” to any of these questions, they are not permitted to participate in any on-ice or off-ice activities.