Race Team Screening

Name

Email

Is your temperature over 100°f?
YESNO

Have you knowingly been in close contact in the past 14 days with anyone who has tested positive for COVID-19 or who has or had symptoms of COVID-19.
YESNO

Have you tested positive for COVID-19 through a diagnostic test in the past 14 days.
YESNO

Have you experienced any symptoms of COVID-19 in the past 14 days.
YESNO

Have you traveled within a state or country with significant community spread of COVID-19 for longer than 24 hours within the past 14 days.
YESNO