KAC Weekly Training - Senior
Health and Safety Notice:
This form must be completed and submitted to KAC prior to attending official training sessions. You should not attend any training session if there is anything contained within current HSE, Government Public Health or Athletics Ireland guidance that would preclude you from attending. Should this be the case you should NOT attend KAC training.

Data Protection Notice:
Your personal data is being collected on this form in order to help prevent the spread of COVID-19 at official KAC training sessions. Your personal data is being processed in accordance with Article 9(2)(i) of the General Data Protection Regulation, and Section 53 of the Data Protection Act 2018. The information you provide on this form will not be used for any other purpose, and will be strictly confidential. This form will be accessible only by the designated COVID Supervisors in your Club and KAC Committee Members. Your personal data will be retained for 3 weeks. By submitting this form you are consenting to KAC to utilize your phone number for official KAC communications.
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Email *
Note that as per Athletics Ireland guidelines from 20th September 2021 the requirement to train in pods of 15 for outdoor activities is REMOVED.
Mobile Phone No *
Track Session - Monday *
Meet at 7.10pm at Shoreline Track. Warm up on Road. Drills on D Section of Track.
Training - Wednesday *
Meet at 7.00pm at Shoreline Track
By signing below and submitting the form I confirm the following

I am š™‰š™¤š™© currently required to self-isolate/restrict movement due to recent overseas travel
I have š™‰š™¤š™© been identified by Public Health as a close contact of a confirmed case of COVID-19 in the past 14 days**
I have š™‰š™¤š™© been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days
I have š™‰š™¤š™© been advised by a doctor to self-isolate or restrict movement at this time
I am š™‰š™¤š™© feeling unwell, felt unwell in the past 48 hours or have any common symptom of COVID-19 including:

š€ ššžš° š‚šØš§š­š¢š§š®šØš®š¬ š‚šØš®š š” - this can be any kind of cough, not just dry
š”š§šžš±š©š„ššš¢š§šžš šš«šžššš­š”š¢š§š  šƒš¢šŸšŸš¢šœš®š„š­š¢šžš¬ šŽš« š’š”šØš«š­š§šžš¬š¬ šŽšŸ šš«šžššš­š”
š…šžšÆšžš« šØš« š‡š¢š š” š“šžš¦š©šžš«ššš­š®š«šž (high temperature -38 degrees Celsius or above)
š‹šØš¬š¬ šØš« šœš”ššš§š šž š­šØ š²šØš®š« š¬šžš§š¬šž šØšŸ š¬š¦šžš„š„ šØš« š­ššš¬š­šž ā€“ this means you've noticed you cannot smell or taste anything, or things smell or taste different to normal

If you have any of these symptoms, you should self-isolate and contact your GP. People in your household will need to restrict their movements.

**If you are are close contact of a person who has tested positive case for COVID-19 that you are in compliance with the HSE Guidance - if you are unsure of these guidelines please contact the KAC COVID officer.


I confirm that the above declaration is true, to the best of my knowledge . I also confirm that I will abide by all government guidelines and make myself aware of any changes to same. I commit to advising KAC and excluding myself if this situation changes (i.e. if at a point in the future I would answer 'yes' to any of the above questions). *

I confirm that I will act in adherence with Athletics Ireland Guidance


NOTE: When on site, please adhere to our Covid-19 Guidelines regarding infection control, i.e. social distancing, hand washing/hand sanitising and general coughing/sneezing etiquette.
Digital Signature *
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