Covid Screener, Team 3-yellow, U10/11 S, 2020-2021 (Milton Minor Hockey)

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:

170 years old or older.
2Gettintreatment  thacompromises  (weakensyouimmunsystem (for example, chemotherapy, medication for transplants, corticosteroids, TNF inhibitors)

      3Having 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 alquestions must be “No in order  to participate in any and alactivity (on-ice or off-ice).

Fo
r 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 anon-ice or off-ice activities.