ADULTS SESSIONS PRE-SESSION HEALTH CHECK
This survey is intended to assist clubs doing basic health and hygiene checks on those members/visitors/spectators attending the club sessions.
PLEASE complete this form online just before leaving home, and on arrival the COVID-19 officer checks (online) the form has been completed.
The information in this form will be kept for 21 days and sent to NHS Track and Trace upon their request

IF you answer DISAGREE to any of the questions you should NOT travel to club and will need to contact the Club COVID-19 officer for more advice before returning to club. This form is only valid for the date that it is completed. A separate form must be completed for each day of participation in club sessions.
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Your First and Last name *
Mobile Phone Number *
Your address *
Your e-mail address *
BFA number
1. I am not experiencing any  of the following Covid-19 symptoms - Fever - New, persistent, dry cough - Shortness of breath - Loss of taste or smell - Diarrhoea or vomiting - Muscle aches not related to sport/training *
2. I have not been diagnosed with COVID-19 within the last 8 days *
3. I have not had any known exposure to anyone with confirmed or suspected Covid-19 in the last 8 days (e.g. close contact, household member) *
4. I do not have any underlying health conditions which affects my immune system(Examples include: chronic respiratory conditions including asthma; chronic heart, kidney, liver or neurological conditions; diabetes mellitus; a spleen or immune system condition; currently taking medicines that affect your immune system such as steroid tablets)  OR     I have underlying health conditions, but I have consulted with a medical professional and am advised it is safe for me to return to fencing. I will provide a copy of this letter to the Club welfare officer. *
5. I have read and agree to the club COVID-19 briefing/instructions/policy *
6. I acknowledge that I am responsible for providing my own equipment and this has been appropriately cleaned since last use. *
7. I will bring my own sanitiser and follow all hygiene protocols, including ensuring that on arrival I wash/sanitise my hands *
8. I agree to follow all instructions given by facility or club officials at the session *
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