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RunFit Kidz COVID Assessment



*Completion is required within 2 hours of every event. By signing this you are agreeing to the validity of this assessment. This assessment is emailed to the email address provided each week - you may print this off or use the one emailed to you by your coach. This form MUST be brought to each class - your child will not be allowed at practice without it.  

If you answered "YES" to any of the following questions, please notify your RunFit Kidz Coach or RFK Owner/Founder corky@runfitkidz.com immediately!

 

Participants Name: _____________________________________________________________

 

1. In the last 14 days, have you been in contact with anyone who has tested positive for COVID-19? Circle response

YES

NO

2. Have YOU been tested for COVID-19 and/or are waiting to receive test results? Circle response. Circle response

YES

NO

3. Since your last RunFit Kidz practice, have you had any of the following symptoms? Circle all that apply or None of the above.

  • Fever of 100.3 F or above
  • Possible fever symptoms like alternating chills and sweating
  • Cough
  • Trouble breathing, shortness of breath, or severe wheezing
  • Muscle aches
  • Sore throat
  • Loss of smell or loss of taste or change in taste
  • Nausea, vomiting, or diarrhea
  • Headache
  • Any other suspicious symptoms
  • NONE of the above


 

4. In the last 14 days, have you been in close proximity to anyone who was experiencing any of the above symptoms or has experienced any of the above symptoms since your last contact with them? Circle response.

YES

NO

5. RunFit Kidz Class Attending (day/time/coach):_______________________________________________

6. Mobile phone number for one parent: (with area code, no spaces):_______________________________ 

7. Parent Signature:______________________________________________________________________