Cobh Pirates RFC - PRE-RUGBY PERSONAL ASSESSMENT DECLARATION

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This form must be completed and submitted to your Club before each and every rugby activity (e.g. training or match). Should you answer NO to the following question, you should NOT attend the Club.

Please input the date you will be attending for training, match or a Club rugby event. *

YYYY

Please enter player name: *

Please enter contact number for tracing: *

I confirm that the player is well and, to the best of my knowledge, have no current symptoms of COVID-19. If the player begins to feel unwell, or develop symptoms of COVID-19, I will not allow the player to attend any upcoming training session/match without first observing the current Public Health guidelines on isolation & restriction of movements. *

Yes

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