Health Survey
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We are working continuously with enjoyleisure, Scottish Swimming and other clubs within East Lothian to make sure our return to club swimming is a safe as possible.

This form is required to be filled out for each child before attending their first MASC training session. You will be emailed by one of the COVID Lead Team after filling out this form to confirm that we have received it and more information about the return.

This form has 2 sections:
1. Health Survey: This is a survey about their member’s health and disclosing details
2. Explicit Consent for Processing COVID-19 Data: This is an acceptance of our additional privacy notice

All information on this form will be kept confidential and not be shared with anyone. If you have any questions please email masccovidteam@gmail.com 

COVID-19 Lead Team
Musselburgh Amateur Swimming Club

Member's Name *
Squad
Date of Birth *
MM
/
DD
/
YYYY
Contact Name *
Contact Email Address *
Contact Phone Number *
If applicable, I agree to bring up to date, named medication with clear instructions of use onto poolside (e.g. inhalers, epipens etc) *
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