Softball W - Declaration Form COVID 19
Name *
Have you travelled to and from any country(ies) within the last 14 days? *
Within the last 14 days, have you had contact with a COVID-19 confirmed or suspect case, or a person issued with a Quarantine Order (QO) / Leave of Absence (LOA) / Stay-Home Notice (SHN)? *
Within the last 14 days, have you had contact with a member in your household who is unwell? *
Are you feeling unwell or having any symptoms (such as fever, cough, muscle ache, joint pain, headaches, sore throat, runny nose, shortness of breath, change in smell, change in taste, diarrhoea)? *
I declare that I have provided the above information truthfully and to the best of my knowledge
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