Fermoy S.C. 'Return To Water' Self Declaration Form (Athletes & Staff) and Code of Conduct
Fermoy Swimming Club Lead Covid-19 Officer: Susan Duggan
Email: fermoycovid19officer@gmail.com


Please note this Self Declaration Form only needs to be submitted once for each Athlete / Staff, prior to Athletes or Staff returning to water
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Swim Ireland accepts that it is not possible for any sport to eliminate the risk of the spread of the COVID-19 virus completely and will work with all stakeholders to minimise risk; this concept must be fully understood and accepted by all Swim Ireland members who wish to return to the water and resume aquatic activities. All club members attending training sessions, including athletes, coaches, Covid-19 officers, persons of duty etc are require to complete and return the updated declaration form to their club by Thursday 30th of September to enable clubs to best plan their ongoing training programme.
This is a once off form that will remove the requirement for daily self-report screening forms.
One of the purposes of the updated declaration form is to alleviate the burden placed on club volunteers and club member by the daily self report screening form. Club members are encouraged to promptly complete and return the declaration form.

In line with GDPR best practice the declaration forms will be held until 30th October 2021, after which they will be safely and securely destroyed.

Club members over 18 in the Republic of Ireland will be asked to indicate their Covid-19 immunity status. Proff of immunity will be required for adults over 18 years of age.

Club member from Northern Ireland attending training or events in Republic of Ireland will be required to provide proof of immunity.

Covid-19 immunity is defined on www.gov.ie as full vaccinated or recovered from Covid-19 within previous 6 months.

Your HSE Vaccination card or your EU Digital Covid Certificate is acceptable as proof of immunity.
Facilities' and clubs may also ask for Photo ID for verification purposes.

Name of Squad Swimmer is a member of ? (Torps, Sharks, Dolphins, Sailfish, Marlins, Swordfish, Glofish) *
Please answer the following questions and Submit. By submitting this form you are agreeing to and accepting the conditions as outlined below
Athlete/Staff Name *
Athlete/Staff Age *
Parent/Carer Name
(Required if Athlete/Staff under 18 Years)
Email *
Date Form is being submitted *
MM
/
DD
/
YYYY
Pre-commencement of training
To be read and agreed by all athletes (and their parent/carer if they are U18)
1: Have you reviewed the relevant protocols issued by your club, understand these, and agree to comply with them? *
If the answer is NO, please notify your Lead COVID-19 Officer by phone. You should not attend any club activities
2: Do you acknowledge the risk of COVID-19 and that you are attending club activities at your own risk? *
If the answer is NO, please notify your Lead COVID-19 Officer by phone. You should not attend any club activities
3: Do you acknowledge that you play a vital role in minimising the spread of COVID-19, over and above the measures implemented by the club? *
If the answer is NO, please notify your Lead COVID-19 Officer by phone. You should not attend any club activities
4: Do you agree to not attend any club training if you have any COVID-19 symptoms, and if a positive test of COVID-19 is received will advise the clubs lead Covid-19 officer? *
If the answer is NO, please notify your Lead COVID-19 Officer by phone. You should not attend any club activities
Do you agree should you identify as a close contact of a COVID-19 case to follow the guidance outlined by the HSE/NI direct and will contact the clubs Lead COVID-19 Officer should self isolation be required. *
5: Do you agree to adhere to all COVID-19 notices at the pooll and at land training venues, agree to adhere to all SI, club and the facility’s COVID-19 measures at the pool and agree to abide by any directions given by club officers while on premises specific to COVID-19 health and safety measures? *
If the answer is NO, please notify your Lead COVID-19 Officer by phone. You should not attend any club activities
6: Do you acknowledge that any measures are subject to change at short notice, where circumstances merit? *
If the answer is NO, please notify your Lead COVID-19 Officer by phone. You should not attend any club activities
7: Do you agree to any changes in the terms and rules of your club membership where necessitated by the COVID-19 crisis, including disciplinary measures where there is non-compliance with health and safety measures and/or directions from club officers? *
If the answer is NO, please notify your Lead COVID-19 Officer by phone. You should not attend any club activities
8: Do you agree to Swim Ireland disciplinary proceeding should you fail to comply with health and safety measures and/or directions from club officers in connection with these protocols ? *
If the answer is NO, please notify your Lead COVID-19 Officer by phone. You should not attend any club activities
All club members are required to agree to the conditions outlined above and digitally sign by 30th September 2021. Please contact the Lead Covid-19 officer should you have any questions or concerns.
Please indicate your COVID-10 immunity status (over 18's Republic of Ireland Only) Covid-19 immunity is defined on www.gov.ie as fully vaccinated or recovered from Covid-19 within previous 6 months. If you do not wish to disclose your immunity status, please contact the Lead Covid-19 Officer via email *
Required
Please (digitally) sign this form to confirm that the details above are true to the best of your knowledge and to confirm that you understand that you understand the risks involved in participation, are participating on a voluntary basis and that may opt-out at any time.
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