Please complete this form prior to each game and practice.  Your responses are retained so the documentation is available to the Parish/Program Athletic Association, District, and to the CYC.

CYC COVID-19 SCREENING QUESTIONNAIRE

1.  Today or in the past 24 hours have you had any of the following symptoms:

• Fever (temperature greater than 100.4 for children and greater than 100 for individuals over the age of 18)
• New or worsening cough
• Shortness of breath or trouble breathing
• Sore throat that as different from your seasonal allergies
• New loss of smell or taste, or both
• Diarrhea or vomiting

2.   Do you have a household member or close contact who has been diagnosed with COVID-19 in the past 2 weeks? (Close contact is defined as prolonged exposure of greater than 10 minutes within 6 feet without a mask.)

By submitting this form, you are confirming that all of the above information is accurate today.   

If you answer "yes" to any of the screening questions, you are not permitted to attend any CYC game, practice, or event as a player, coach, volunteer, or spectator. 

*If you have tested positive for COVID-19, are awaiting test results, or have had significant exposure to a positive COVID-19 individual, then you should not participate or attend. Parents are obligated to contact their Athletic Association to notify them of a positive diagnosis of COVID-19.  Athletic Associations will notify their District Coordinator.