Covid-19 Pre-Screening - BHOH

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Covid-19 Pre-Screening

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This form must be completed 24 hrs prior to the Program being attended! Failure to do so will deny attendance of the Program!
Contact Person
Please fill in the following information if you are the participant in an Adult Program or the guardian/parent of the child participant.







Failure to complete the following sections will result in denial to participate and/or watch your child participate.
Child Participant Info (Required for ALL Tot, Teen and Youth Programs)



Child Participant Assistant Info (Parent & Tot Programs ONLY) Complete even if same as person completing this form!



Parent/Guardian Attendee (person staying as spectator) Complete even if same as person completing this form!




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