Southern Gauteng schools hockey COVID SCREENING

All of Southern Gauteng schools coaches, players, managers, umpires or any other related person entering the school/ venue for sports purposes needs to complete this form upon entry

If you do not not complete the form you are not allowed to enter the venue by regulation.

NB: No spectators are allowed.
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Player name and surname: *
E-mail address *
Cellphone number *
Date of practice/ game *
Time *
Reason for entering venue: *
Venue (Alphabetically) *
COVID-19 Symptoms
If you answer yes to any of these symptoms, please refrain from entering the venue
Attending a session at the venue whilst having any of the symptoms puts management, coaching staff and fellow players at risk.
Please select all relevant options: *
I knowingly and willingly consent to attend Hockey training as permitted under current Alert Level Regulations at all venues opened by the GDE.

I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious.

I understand that due to the frequency of visits of other hockey players, the characteristics of the virus, and the characteristics of hockey activities, that I have an elevated risk of contracting the virus simply by being at the hockey venue.

High risk patients relating to the severity of COVID-19 are persons over the age of 60 and persons who have pre-existing medical conditions such as: asthma, chronic lung conditions, hypertension, autoimmune disease, organ transplants, cancer, immunocompromised, obesity (BMI over 40) and liver or kidney disease conditions.

I acknowledge that if I have tested positive for COVID-19, a letter from a doctor confirming a subsequent negative test must be submitted my school as well as Southern Gauteng schools management prior to being permitted back on to the field.

I understand that should I have a pre-existing condition which increases my risk that I need to declare it.
I am aware of the risks involved with the spread of COVID-19 and the risks it may hold to my health and the health of others I come in contact with.

I accept those risks and hereby indemnify and hold the SASHOC, SOUTHERN GAUTENG SCHOOLS and all SAHA/SGHA certified venues opened and their staff blameless should I contract the disease at the hockey venue or from the venue staff members.

I will abide by all the regulations and rules for participation in hockey as laid out in the COVID-19 SA Hockey Operational Guidelines, Return to Play Framework and the venues I am training at.

I have read and understood the terms of this indemnity as laid out and confirm I will comply thereto and prepare accordingly.
By checking this box, you are digitally and legally agreeing to the declarations as stated above * *
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