EmailMeForm
COVID-19 | Reporting a Positive Test
Your Name
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First
Last
Email address
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Your best phone #
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Name of Your Club
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Your position in your club
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Club President
Club Registrar/Admin
Club Board Member
Club Treasurer/Financial Contact
Club Technical Leader
Club Executive Leader
Club Risk Management Coordinator
Club Coach
Click all that apply
I have been authorized to submit this report on behalf of my club
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Yes
No
Date positive test was confirmed for this person
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MM
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DD
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YYYY
Associated Team(s) Info
We need information about which team(s) the person who tested positive is rostered to or associated with
Team #1 Name
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Team #1 Age Group
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4U Boys
4U Girls
5U-6U Boys
5U-6U Girls
7U-8U Boys
7U-8U Girls
9U-10U Boys
9U-10U Girls
11U-12U Boys
11U-12U Girls
13U-14U Boys
13U-14U Girls
15U-16U Boys
15U-16U Girls
17U-18U Boys
17U-18U Girls
19U Boys
19U Girls
Person who tested positive is a
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Player
Coach
Other
Team #1 - Most recent date the person had contact with the team
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MM
/
DD
/
YYYY
List all opponents Team #1 came into contact with in the 7 days prior to the date the person tested positive and/or developed symptoms
If none, enter "N/A"
*
League game, friendly or scrimmage, tournament game, festival game, etc....
If person on more than one team, complete this section
Team #2 Name
Team #2 Age Group
4U Boys
4U Girls
5U-6U Boys
5U-6U Girls
7U-8U Boys
7U-8U Girls
9U-10U Boys
9U-10U Girls
11U-12U Boys
11U-12U Girls
13U-14U Boys
13U-14U Girls
15U-16U Boys
15U-16U Girls
17U-18U Boys
17U-18U Girls
19U Boys
19U Girls
If person on more than one team, complete this question
Person who tested positive is a
Player
Coach
Other
Team #2 - Most recent date the person had contact with the team
MM
/
DD
/
YYYY
If person on more than one team and also had contact with this team, complete this question
List all opponents Team #2 came into contact with in the 7 days prior to the date the person tested positive and/or developed symptoms
If none, enter "N/A"
League game, friendly or scrimmage, tournament game, festival game, etc....