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ERGS Covid-19 Declaration
This declaration needs to be completed by all rugby players and coaches prior to returning to training/matches. If you answer “YES” to ANY of the questions you should NOT attend training or play matches. If your circumstances change in the period since you complete the declaration you will need to submit a second declaration before returning to rugby. Any queries please get in touch with Mr Finlay.
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1. Do you have symptoms of cough, fever, high temperatures, sore throat, runny nose, breathing difficulties, flu like symptoms, rash, loss of smell/taste now or in the past 14 days?
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Yes
No
2. Have you been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days?
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Yes
No
3. Are you in close contact with a person who has had a confirmed or suspected case of COVID-19 in the past 14 days (i.e. less than 2 metres for more than 15 minutes accumulative in 1 day?
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Yes
No
4. Have you been advised by a doctor to self-isolate at this time?
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Yes
No
5. Have you been advised by a doctor to cocoon at this time?
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Yes
No
6. Please provide details below of any other circumstances relating to COVID-19, not included in the above, which may need to be considered to allow your safe return to rugby?
Your answer
7. Have you travelled to/from another country in the past 14 days, or have you been in close contact with anyone who has been outside of the country in the past 14 days? (I commit to advising coaching staff and excluding myself if this situation changes in the future)
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Yes
No
8. “I confirm all the information I have provided in this form is accurate to the best of my knowledge.” Please enter your full name below as a digital signature you agree with this statement.
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Your answer
9. Please enter the date on which you have provided the digital signature above.
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YYYY
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