Covid-19 and Risk Awareness Declaration (Apr 21)
Name of Attendee
Details of person who will be present at facility (i.e. swimmer, coach, Covid liaison, under 8's parent)
Your's or your child's squad/class, Coach / Staff, Visitor / Other
Black & Purple
Learn to Swim
Staff / Coach
Other / Visitor
I, (the aforementioned) am attending training having completed and signed the Health Survey as requested by Orpington Ojays Swimming Club (“OOJSC”).
** In the interest of the safety of you and your fellow club members, please read the following important statement before submitting your declaration **
By submitting this declaration, I confirm I am 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 accompanying me is also symptom free from the virus.
By submitting this declaration, I confirm that for any future training sessions I will only attend in the full knowledge that I am free from any Covid-19 symptoms. In addition, but conversely confirm by submitting this declaration that if I do display any symptoms I will not attend for a period of at least 10 days and follow government guidance to self-isolate.
I am also confirming all in my household will follow the government guidance on quarantine and self-isolation following any travel abroad. See
I attend training knowing that my presence cannot be without risk, I am therefore aware of these risks associated with the Covid-19 virus, but still wish to attend club training.
I understand the processes and protocols OOJSC have put in place in order to reduce risks and I will adhere to these in order to protect my 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 will change.
Risk awareness submission
By checking this box and adding my name I understand and submit this declaration as an accurate statement
Name of Parent or Guardian (if under 18)
I understand and submit this declaration as an accurate statement
Thank you for your continued co-operation and support of our club
Orpington Ojays Swimming Club
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service