Health check form | Barnsleyfencingclub

Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Phone

I am not experiencing the symptoms: fever, cough, sore throat

My body temperature is lower than 98.6°F/ 37.5°C

I haven’t been in close contact with a Covid-19 patient in the last 14 days

I will bring my own sanitiser and follow all hygiene protocols, including ensuring that on arrival I wash/sanitise my hands and social distance where possible

Date

I declare that the info I’ve provided is accurate & complete

Participants not able to confirm ANY of the questions should not travel to the club and will need to contact the Club COVID-19 officer for more advice before returning to the 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