Gauteng Covid Screening Questionnaire

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This form is compulsory for all TSA tournament players and has to be submitted on the day of each event entered.

Name and Surname of Player *

Email *

Contact Number *

Date of play *

YYYY

HAVE YOU BEEN IN CONTACT WITH ANYONE THAT HAS HAD COVID-19? * *

Yes

DO YOU EXPERIENCE ANY COVID-19 RELATED SYMPTOMS? * *

Yes

TO THE BEST OF YOUR KNOWLEDGE, ARE YOU CURRENTLY FREE OF COVID-19? *

Yes

I HEREBY DECLARE THAT I AM FIT, AND IN GOOD HEALTH TO PLAY. * *

Yes

I hereby declare that the information I have provided is true and accurate to the best of my knowledge. Please sign with your full name. * *

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