Health Declaration | The Owls Nest

Race participants will be required to complete 48 hours prior to race day. Participants who fail to do so or decline will be disqualified without a refund. Note: The information collected on this form will be used to determine only whether you may be infected with COVID-19. The information on this form will be maintained as confidential.

The Owls Nest Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

My body temperature is lower than 98.6°F/ 37.5°C

I am not experiencing the symptoms: fever, cough, sore throat

I haven’t been in close contact with a Covid-19 patient in the last 14 days

Within the past 14 days, I have not been told by a health or medical professional told you to self-monitor, self-isolate, or self-quarantine because of concerns about COVID-19 infection?

I have not come into close contact (within 6 feet) with someone who has a laboratory-confirmed COVID-19 diagnosis in the past 14 days?

Name

Date

I declare that the info I’ve provided is accurate & complete. You certify that the answers above are true. Failure to answer truthfully or withholding information intentionally will lead to disqualification from all current/future events and may be subject to applicable laws during this pandemic.

Thanks for submitting!

The Owls Nest Covid-19 Health Declaration

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The Owls Nest

301 s. Washburn Ste. D

Decatur, TX 76078

940-252-4158