Daily Check-In Form

Daily Check-In Form 2021
I am here for... *
I am a... *
All participants and coaches must have a B2 Courts Waiver and Release of Liability on file. Please confirm *
Are you experiencing one or more of these symptoms: Severe, constant chest pain or pressure | Extreme difficulty breathing | Severe, constant lightheadedness | Serious disorientation or unresponsiveness *
Are you diagnosed with or has your healthcare provider told you it is likely you have COVID-19? *
Are you experiencing one or more of these symptoms that can’t be explained by another condition (like seasonal allergies or asthma): Fever or chills (Fever is 100.4F (or 38.0C) or more) | Mild or moderate difficulty breathing | New or worsening cough | New loss of smell, taste, or appetite | Sore throat | Vomiting or diarrhea | Unexplained muscle aches | Feeling unusually weak or fatigued
In the last 14 days, what is your exposure to others who are known to have or have symptoms of COVID-19?
By checking the box below, you are confirming you have read and understand B2 Courts COVID-19 Policies & Procedures and will abide by them.

%d bloggers like this: