Covid-19 and Risk Awareness Declaration
Sign in to Google
to save your progress.
First Name + Last Name of member/swimmer
I/My child, named above, will be attending swim training having completed and submitted the Health Survey as requested by St Austell ASC.
By submitting this declaration, I confirm that I/my child am/is free from any symptoms related to the Covid-19 virus, I understand the main symptoms include:
A high temperature - this means you feel hot to touch on your chest or back.
A new, continuous cough - this means coughing a lot for more than an hour, or three or more coughing episodes in 24 hours.
A loss or change to your sense of smell or taste.
I am also confirming all in my household remain symptom free, and anyone taking me to or from training and attending my training session with me is also symptom free from the virus.
By submitting this declaration, I confirm that for any future training sessions I/my child will only attend in the full knowledge that I/my child am/is free from any Covid-19 symptoms. In addition, but conversely confirm by submitting this declaration that I/my child do/does display any symptoms I/my child will not attend training for a period of at least 10 days and follow the government guidance to self-isolate.
I am also confirming all my household will follow the government guidance on quarantine and self-isolation following any travel abroad.
I/My child return/s to training knowing that preparation cannot be without risk, I am therefore aware of these risks associated with the Covid-a9 virus, but I still wish/I still wish my child to participate in club training.
I understand the processes and protocols St Austell ASC have put in place in order to reduce risks and I/my child will adhere to these in order to protect my/my child's health and the health of other members, staff and other users of the facility.
I also understand that the club will have to be flexible and responsive due to the evolving government advice around Covid-19, and the fact that circumstances may change
Full Name of parent submitting this declaration (if swimmer under 18)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service