Kingsgate 3&4 Health Check

Please review and sign 


Have you or your child experienced a fever of 100 or greater in the past 10 days?

Have you or your child received a POSITIVE result from a COVID-19 test within the past 10 days (You can answer NO if you have a more recent NEGATIVE (all clear) test.)

In the past 10 days, have you or your child been in close contact with anyone that has or had symptoms of COVID-19 that required you to quarantine?

In the past 10 days, have you, your child, and someone you have been in close contact with traveled to an area that required quarantine upon return?

In the past 10 days, have you or your child experienced any of these symptoms that are not attributed to another health condition: cough, loss of smell or taste, runny nose, shortness of breath, or a sore throat?

If you need to sign the Kingsgate Covid Waver Click Here

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND I FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE. In addition, if I have listed any minors above, I am the parent or legal guardian of the minor(s) named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions herein on their behalf and I agree to assume the risks and waive their rights concerning liability as described above.


By signing here, you are consenting to the use of your electronic signature in lieu of an original signature on paper.

Thank you for Submitting.

If you have answered Yes to any of the Questions, Please stay home and Your Coaches have been notified that you are not able to attend Swim Team.

They will reach out to discuss how long you will need to quarantine.