Stockport Harriers & AC 21/22 Season
Athlete Risk Assessment and Pre Training Wellness Check.
Completion of this form is mandatory for attendance at training, you only need to complete the form once before training at the start of the new season.
All information will remain confidential. A separate form is required for each athlete.
Questions highlighted with a red star must be completed
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Email *
Section 1 - About you.
Your Full Name *
Are you a current 21/22 Member of Stockport Harriers & AC (Please also tick yes if current for 20/21) *
Are you an Athlete/Coach/Parent or Guardian/Other please tick primary role: *
Add your membership number here if you know it. You can find this in MemberMojo
Your contact telephone number (Parent/Guardian if U18) *
Section 2 - About your coaching group
Select the name of your lead coach *
Required
Please let us know which days you attend training sessions *
Required
Section 3 - Your Health
Have you ever been diagnosed or tested positive for Covid-19 - if the answer to this question is yes please contact your coach directly to discuss this. *
Are you experiencing any Covid -19 related symptoms -Fever, new persistent dry cough, shortness of breath, loss of taste or smell, diarrhoea or vomiting or aches not related to activity. IF YES AT ANY POINT -DO NOT attend training and consult your GP *
Have you had a known exposure to anyone with confirmed or suspected Covid-19 within the last 14 days? IF YES you are required to seek a test and check the current government advice regarding self isolation (Please do not attend training while you or anyone in your household or bubble awaits a Covid-19 test result).
Clear selection
I confirm that myself & everyone in my household remains free of Covid 19 symptoms and that anyone attending training sessions with me is also free from any Covid-19 symptoms. *
Required
I confirm that I will only attend any sessions in the knowledge that I am free from symptoms and that if I develop any symptoms I will not attend any training sessions and will follow government guidelines to self isolate for 10 days *
Required
Testing - Testing kits are available to all by delivery or collection from local test sites. Are you currently undertaking regular lateral flow tests either via your school or household? *
Section 4 - Reducing Risks
Steps you must take to minimise the risks
Are you able to ensure that you observe the 2m social distancing rule at all times when mixing with individuals from other households, this includes coaches. YES response required. *
Do you have hand sanitising gel available to you for use on entry, during the session when required after touching any equipment or the gates at the track? YES response required *
It is important that you bring a small first aid kit and personal PPE consisting of mask & gloves to each session. You may be required to use your PPE if in an emergency you need to receive first aid from a person not from your household. A mask will also be required to enter the clubhouse and use the accessible toilet. DO you have this available? YES response required. *
AGREED ACTION PLAN *
Required
DECLARATION I understand that there is risk attached to attending any sessions but that I agree to follow the guidelines set out by Stockport Harriers and AC to help reduce that risk. *
A copy of your responses will be emailed to the address you provided.
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