BCAQ Daily Health Check – Synchronized Swimming Club – BC Aquasonics High Performance Synchro

This MUST BE COMPLETED each time you are entering any training facility and MUST BE COMPLETED within 3-hous of your arrival.

2. Have you, or has anyone in your household, travelled outside of Canada in the last 14 days?*
- Yes
- No
3. Have you, or anyone in your household, within the last 14 days, had close contact, resided with, or cared for someone without protection who has or is suspected to have COVID-19?*
- Yes
- No
4. Have you been notified by a public health authority or healthcare provider that you, or anyone in your household, may have been exposed to COVID-19 and/or that you should self-isolate?*
- Yes
- No
5. Have you been diagnosed with a suspected or confirmed case of COVID-19 and has it been less than 14 days since the later of your diagnosis or the ending of your symptoms, if any?*
- Yes
- No
If you answered “NO” to questions 2-5, you may enter the training environment.

I, the Participant acknowledge that I have answered all questions as accurately as possible.
Consent*
I agree to the privacy policy.
I acknowledge that the BC Aquasonics will store all this information as part of safety protocols related to Covid-19 and contact tracing. In addition, this information may be shared with BC Government, Health Authorities and other entities as required in order to support and identify contact tracing.