Abingdon Fencing Club - COVID-19 Pre-Session Health Check (Juniors)

Page 1

Fields

Full Name of Parent / Guardian Name Completing this form *
First Name / Surname to be entered
Mobile Number *
Mobile Phone number to be provided
Email Address *
Name Of Fencer *
Age of Fencer *
Section *
Please select the session being attended - Juniors
Session Date *
Please select date of attendance Note - This form can only be submitted one day in advance of attendance date
Confirmation that I'm fit to participate *
Participants answering DISAGREE to any of the questions should not travel to club and will need to contact the Club COVID-19 officer for more advice before returning to club. This form is only valid for the date that it is completed. A separate form must be completed for each day of participation in club sessions.
I'm not experiencing any COVID-19 symptoms *
• Fever • New, persistent, dry cough • Shortness of breath • Loss of taste or smell • Diarrhoea or vomiting • Muscle aches not related to sport/training
Not been diagnosed with COVID-19 *
I have not been diagnosed with COVID-19 within the last 4 weeks
No known exposure to with confirmed or suspected COVID-19 in last 2 weeks *
I have not had any known exposure to anyone with confirmed or suspected Covid-19 in the last two weeks (e.g. close contact, household member)
No underlying Health Conditions *
(Examples include: chronic respiratory conditions including asthma; chronic heart, kidney, liver or neurological conditions; diabetes mellitus; a spleen or immune system condition; currently taking medicines that affect your immune system such as steroid tablets)
Read and agree to Club's COVID policy *
I have read and agree to the club COVID-19 briefing/instructions/policy
Whose equipment is being used? *
Please select one of options
I'm using Club Equipment which Cleaned since last use *
This field should be set to disagree if you have you own equipment - otherwise the fencer cannot attend this session
I'm responsible for providing own Equipment and Cleaned since last use *
This field should be set to disagree if you have you are using club equipment - otherwise the fencer cannot attend this session
I will bring/use provided Sanitiser / follow Hygiene Protocols *
I will bring my own sanitiser and follow all hygiene protocols, including ensuring that on arrival I wash/sanitise my hands
I agree to follow instructions at each session given by facility / club *
I agree to follow all instructions given by facility or club officials at the session