COVID 19 Screening

Are you experiencing any of the following symptoms with unknown cause?
New or Worsening cough?(Required)
Shortness of breath or difficulty breathing?(Required)
Feeling feverish – temp(Required)
Chills?(Required)
Fatigue or weakness?(Required)
Muscle or body aches?(Required)
New loss of smell or taste?(Required)
Headache?(Required)
Gastrointestinal symptoms?(Required)
Feeling very unwell?(Required)
Have you had contact with any person with, or under investigation for, COVID-19 in the last 14 days?(Required)
Have you or anyone from your immediate hoursehold travelled outside Canada in the past 14 days? (for non-essential travel)(Required)
In the past 10-14 days, have you been required to quarantine or isolate by your local public health authority?(Required)
If you have answered YES to any of the questions above, ATSA management requests you leave the venue and contact AHS for a covid test & isolate yourself from other participants to lower the risk of contamination to others.
Participants Name(Required)
Clear Signature
Signature required by parent or guardian if participant is under 18.