Blue Dragon Spirit Squad Open Gym Questionaire

Email Secondary Email

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Click which Open Gym you wish to particiate in: *

Dance Cheer

Email address *

First name *

Last name *

Address 1 *

Address 2

City *

State *

ZIP Code *

Cell Phone Number *

Students must fill out this questionaire along with a waiver pertaining to open gym to particiate in Blue Dragon Spirit Squad Open Gyms.

Please answer the following questions ... these are required:

Today or within the last 24 hours, have you experienced any of the following symptoms that are not normal for you:

Fever of 100.4 or greater *

Yes No

Repeated Shaking or Chills *

Yes No

Lost of Taste or Sense of Smell *

Yes No

Shortness of Breath or difficulty breathing - no associated with pre-existing condition (i.e. asthma) *

Yes No

Cough (new or different than normal) *

Yes No

Muscle or Body Aches *

Yes No

Diarrhea/Upset Stomach/Nausea *

Yes No

Sore Throat *

Yes No

Headache *

Yes No

Congestion or runny nose (not associated with pre-existing condition i.e. seasonal allergies) *

Yes No

Have you been in close contact with someone who has been diagnosed with COVID-19 in the past 14 days? *

Yes No

The Blue Dragon Spirit Squad head coach will review the questionaire to mke sure all students who have signed up to participate are eligible to attend Open Gym. The Open Gym will be first-come, first-serve to the first 20 athletes who have been approved to attend.

Athletes who are approved will receive notification by email. A fee of $20 (cash or check) will be collected at the door. Checks will be made out to Hutch CC Endowment.

CLICK TO FIND WAIVER FORM IN PDF FORMAT

* required field