Your Waiver
Toggle navigation
Home
Krav Maga Dallas
COVID-19 CORONAVIRUS INFECTION & SYMPTOM WAIVER
I am filling out this form on behalf of
Myself
A minor
Your Name (or your minor's name)
Is the student required to wear a mask during training?
No
Yes
In the past 14 days have you (or your minor) had any KNOWN prolonged, close & direct contact with any person with a lab-confirmed case of COVID-19?
No
Yes
Do you currently have a fever of over 100.4?
No
Yes
In the past 14 days have you been in a group setting of more than 50 people where COVID guidelines have not been maintained (no social distancing or masks)?
No
Yes
Are you (or your minor) experiencing any of the following symptoms? (Check ALL that apply)
Loss of Taste or Smell
Cough
Difficulty Breathing
Shortness of Breath
Headache
Chills
Sore Throat
Shaking or Exaggerated Shivering
Diarrhea
Significant Muscle Pain or Ache
NONE OF THE SYMPTOMS LISTED ABOVE
Submit