DW Moorhead Renegades
COVID-19 Symptoms Checklist
Covid-19 Symptoms Checklist
for Team Personnel, Players & Referees
1. Do you have any of the below symptoms?
Fever (greater than 38.0C) YES NO
Cough YES NO
Shortness of Breath / Difficulty Breathing YES NO
Sore Throat YES NO
Runny Nose YES NO
2. Has anyone in your household experienced any of the above YES NO
in the last 14 days?
3. Have you, or anyone in your household travelled outside of YES NO
Canada in the last 14 days?
4. Have you, or anyone in your household been in contact in the YES NO
last 14 days with someone who is being investigated or
confirmed to be a case of Covid-19?
5. Are you currently being investigated as a suspect case of Covid19? YES NO
6. Have you tested positive for Covid-19 within the last 10 days? YES NO
If an individual answer ‘YES’ to any of the questions above, they are not to be permitted to participate in training for a minimum of 14 days.