MBCY Sports Registration Form - 2021

Full Name *

Email Address *

Phone Number (no symbols. Example - 6465555555) *

1) Have you or any of the people attending with you, experienced any symptoms of COVID-19, including a fever of 99.5 degrees or higher, coughing, loss of taste or smell, or shortness of breath within the past 14 days?  *

Yes

2) In the past 14 days, have you or any of the people attending with you, tested positive for COVID-19 from a certified test facility, clinic, or hospital? *

Yes

3) To the best of your knowledge, in the past 14 days, have you and those attending with you, been in close contact (within 6 feet for at least 10 minutes) with anyone who tested positive for COVID-19 or who has or had symptoms of COVID-19? *

Yes

4) Have you or any of the people attending with you, traveled internationally (including cruises) or from a state with widespread community transmission of COVID-19 as per the New York State Travel Advisory (Click here) in the past 14 days? *

Yes