Brixton Fencing Club health check
This form needs to be completed EVERY TIME YOU ATTEND a training session
Email address *
Name *
Contact number *
If you do not agree with all the health statements below, DO NOT TRAVEL TO THE CLUB and contact the Club COVID-19 officer.

1. I am not experiencing any of the following: fever, new, persistent, dry cough, shortness of breath, loss of taste or smell,
diarrhoea or vomiting, muscle aches not related to sport/training
2. I have not been diagnosed with COVID-19 within the last 4 weeks
3. 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)
4. Either I do not have any underlying health conditions which affect my immune system or I do have such conditions but have
been advised by a medical professional that it is safe for me to return to fencing.
5. I have read and agree to the club’s COVID-19 policy
6. The equipment owned by me or lent to me has been appropriately cleaned since last use.
7. I will bring my own sanitiser and follow all hygiene protocols, including ensuring that on arrival I wash/sanitise my hands
8. I agree to follow all instructions given by facility or club officials at the session
Before fencing you are required to have a coach or committee member go through a full COVID-19 safety briefing
If you have not attended a briefing find a coach or committee member when you arrive and before you get changed and you will be shown the clubs policy.

DO NOT TRAVEL TO THE CLUB if any of the statements in the previous section are not true.
I agree with ALL of the statements above. *
Required
A copy of your responses will be emailed to the address you provided.
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