Southbank CUACO COVID-19 Self Assessment
Could all players & volunteers kindly fill out this form before EACH training session & match day. Failure to do so may result in a delayed start (once you have filled it out) or you may be asked to leave.
First Name *
Surname *
Email Address *
Contact Number *
Have you recently developed a new, continuous cough? *
Do you feel as though you have a high (above 37.8°C) temperature? *
Have you recently been in close contact with/living with someone with a suspected or confirmed case of COVID-19 in the last two weeks? *
Have you recently suffered a shortness of breath, a loss, or change to, your sense of smell/taste? *
Which Southbank squad have you been selected to play for today? (Apt on match-days only)
Lastly, have you read and do you agree with the Southbank CUACO privacy/GDPR policy & also the Code of Conduct policy? This can be obtained here: *
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