COVID-19 SCREENING FORM (Port Dover Minor Hockey)

Print COVID-19 SCREENING FORM
CONTACT INFORMATION
  1. A receipt of this submission will be sent to the email address provided. This receipt must be shown at the arena door to gain entry.
  2. Example: ###-###-####
COVID-19 SCREENING QUESTIONNAIRE
  1. Exact times can be typed if not available on the time picker.
  2. RadDatePicker
    RadDatePicker
    Open the calendar popup.
    Not required if you have not travelled outside of Canada in the previous 14 days.
Human Validation
Printed from pdmha.com on Wednesday, December 2, 2020 at 8:17 PM