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Victoria Soccer Club - Self Assessment Health Questionnaire

Email*

Date of game* required

Time of game

Choose a time

1. Does the player attending today's session have any of the below symptoms:

If you have answered YES to any of these above questions you may not play today. Go home
and please use the AHS Online Assessment Tool to determine if testing is required.
Thank you so much for your help.

Submit

First Name*

Last Name*

Facility Rules/Covid Info

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