Report "*" indicates required fields COVID-19 Report We want to keep all players, parents, staff and officials safe. Should you have been diagnosed with COVID-19 please submit this form to notify CCSA . Your information will remain confidential. Players First Name*Players Last Name*Email Address* Players Date of Birth* MM slash DD slash YYYY Players Program Name / Team Name / Age Group*Date of last attended session at CCSA* MM slash DD slash YYYY Have You Tested Postive For COVID-19?* Yes No Date diagnosed with Covid-19* MM slash DD slash YYYY Start Date of Quarantine MM slash DD slash YYYY End Date of Quarantine MM slash DD slash YYYY Coaches Name (if known)*CAPTCHA Δ
