COVID 19 Screening Form (Stratford Aces Girls Hockey)

Print COVID 19 Screening Form
Please complete this form and bring a copy to the arena for every ice time. DO NOT SUBMIT ELECTRONICALLY This questionnaire must be completed by each individual (players and parents if attending the arena) prior to participation in each on-ice or off-ice activity.
  1. Example: yo[email protected]. Your submission will be sent to this address.

  2. Check All That Apply
  3. If you answer YES to any one of the questions above, PLEASE DO NOT enter this location AND contact your health care provider or Telehealth Ontario (1-866-797-0000) to get advice or an assessment, including if you need a COVID-19 test.

    If you have answered yes to any of the questions, please inform your Coach and email the COVID coordinator at [email protected] 
Human Validation