JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
ESFC Covid-19 Symptoms Checker
ESFC is screening all visitors, players and coaches daily and should you not fill in the below questionnaire you will have to do so at the venue before being allowed access.
If a "YES" response is given to any of the questions below, you will unfortunately not be able to play or train at our venue. Playing sport while you have any of the following symptoms is generally discouraged for your own safety. Due to the outbreak of COVID-19 we have to enforce these measures to protect other players and coaches against the outbreak.
Please complete this by no later than 15:00 on the day of your scheduled arrival.
Sign in to Google
to save your progress.
Learn more
* Required
Email
*
Your email
Player Name
*
Your answer
Contact number
*
Your answer
Training Group
*
Choose
Ladies
Girls
Social Ladies
Under 6
Under 7
Under 8
Under 9
Under 10
Under 11
Under 12
Under 13
Under 14
Under 15
Under 16
Under 17
Coaching/Technical session
Date of training
*
MM
/
DD
/
YYYY
Do you have any of COVID-19 Symptoms including high temperature, cough, sore throat, difficulty breathing, feel weak or tired, lost sense of smell or taste, feel nauseous and/or been vomitting? *
*
Yes
No
Specify any COVID-19 symptoms if you answered Yes to the previous question
Your answer
Have you or any of your household been in contact with anyone that has tested positive for COVID-19 or is awaiting test results, with in the last 2 weeks?
*
Yes
No
Temperature reading (in degree Celsius) on the day of training
*
Your answer
By submitting this form you agree and understand our strict health and safety protocols and will abide by them.
Yes
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms