Delaware Premier League 2024

    Player Name

    Select Team

    In the past 24 hours, have you experienced:

    Date:

    Fever:

    Fatigue:

    Cough:

    Sneezing:

    Aches and Pains:

    Runny or Stuffy Nose

    Sore throat:

    Diarrhea:

    Headaches:

    Shortness of breath:

    Have you recently been in close contact with anyone who has exhibited any symptoms?

    Have you recently been in contact with anyone who has tested positive for COVID - 19?

    Have you recently traveled to a restricted area that is under a Level 2, 3, or 4 Travel Advisory according to the U.S. State Department? Including: China, Italy, Iran, and most countries in Europe.