COVID ENTRY FORM 2021-22 (Loyalist Township Minor Hockey)

Print COVID ENTRY FORM 2021-22
Please complete the screening procedure no earlier than 2 hours before entry. PLEASE ENTER FIRST AND LAST NAME OF ALL ENTRANTS! The form will automatically enter the time that the form is submitted so please follow this expectation. You will be asked by our volunteer at the door to confirm that the form is submitted and complete. The information collected will be stored by Loyalist Township Minor Hockey in a secure server for collection by the Public Health Unit if requested. Failure to complete this form may lead to exclusion from further LTMHA events.
  1. Complete the online Ontario Customer Screening Tool for all participants and spectators entering the Henderson Arena for your immediate group.
  2. Must be completed
  3. Example: ###-###-#### x###

  4. As mandated by the Government of Ontario under the Reopenoing Ontario Act.
  5. No other person other than the player and/or his/her companion who will enter the facility may complete this screening.

    All spectators 12 years old and over must show proof of double vaccination plus 14 days.

    All players and minor hockey volunteers over 18 years old must show proof of double vaccination plus 14 days.

    This Health Screening Questionnaire has been developed based on the Ontario Ministry of Health Self Assessment Tool (June 17, 2020) and Hockey Canada and the Ontario Hockey Federation


    All completed Screening Questionnaires are held in complete confidence and are maintained for Contact Tracing Purposes should the KFLA Health Unit request it.

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Printed from on Saturday, December 4, 2021 at 12:36 PM