HWSC Return to Training Online Consent Form
Covid-19 and Risk Awareness Declaration
This Consent Form must be submitted BEFORE Monday 10th August 2020
Swimmer's First name
Club and Masters
Please read carefully, then sign and date this Consent Form below
I am returning to training having read and returned where appropriate the Covid19 Health Screen Form as requested by Havant and Waterlooville Swimming Club.
you feel hot to touch on your chest or back
By signing this declaration, I confirm that the swimmer named above is free from any symptoms related to the Covid19 virus, I understand the main symptoms include:
• a high temperature – this means you feel hot to touch on your chest and 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 the sense of smell or taste.
I am also confirming that everyone in my household remain symptom free, and anyone taking the swimmer to or from training and attending the training session with the swimmer is also symptom free from the virus.
By signing this declaration, I confirm that for any future training sessions the swimmer will only attend in the full knowledge that they are free from any Covid19 symptoms.
In addition, but conversely confirm by signing this declaration that if they do display any symptoms they will not attend training for a period of at least 14 days and follow government guidance to self-isolate and will inform the HWSC Covid19 lead
The swimmer named above returns to training knowing that their participation cannot be without risk, and is aware of these risks associated with the Covid19 virus, but still wishes to participate in club training.
I understand the processes and protocols Havant and Waterlooville SC 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.
Signature of swimmer (this can be typed)
Parent/guardian signature (for members under 18)
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of University of Portsmouth Staff.