Ards Swimming Club - Junior Squad
COVID-19 Swimming Health Questionnaire - COMPULSORY
Sign in to Google to save your progress. Learn more
Swimmers Name *
Swimmers Age *
Session Time *
Have you travelled to any country (outside of all-Ireland) in the last 14 days? ifYES please notify the lead COVID-19 Officer. If you have travelled to a destination listed on the relevant Government Green List, you will not be required to restrict your movement but must notify the club in advance of return to training. If you have travelled to any other destination you should not leave home and you should not travel to the pool.  You should avoid contact with any other club members for 14 days (from the time of your return).  If you are symptom free for 14 days, you may return to the club. *
Have you been in contact with a case of COVID-19 (>15 minutes face-to-face contact? If YES, please notify the Lead COVID-19 Officer by phone. You should not leave home and you should not travel to the pool. We recommend you contact your GP for advice If No, please proceed to the next question. *
Have you been contacted by a member of public health about a recent case of COVID-19? IF YES, please notify the lead COVID-19 officer by phone. You should not leave home and you should not travel to the pool. We recommend you contact your GP for advice. *
Do you have any of the symptoms below in the last 48 hours? If the answer is yes, please notify the COVID-19 officer by phone. *
Required
In the last 14 days, have you or anyone  you have been in close contact had exposure to anyone who has / may have COVID-19 - IF YES PLEASE NOTIFY COVID-19 OFFICER *
Have your swimmer/s had a high temperature in the last 14 days? *
Have your swimmer/s a new continuous cough? *
Have your swimmer/s a new unexplained shortness of breath or similar symptoms? *
Have your swimmer/s any loss of sense, of smell, of taste or distortion of taste? *
Have your swimmer/s any other possible symptoms of COVID-19? *
Safe return to swimming will involve agreeing to complete this form and informing the club of any changes that may appear. Do you agree? *
As the parent of the swimmer/s - it is your responsibility to ensure that your swimmer/s are fit and healthy to be at the swimming session and have due care. *
Do you understand that if your swimmer/s arrive for training and appear to be unwell and / or show symptoms - they will not be able to take part in the swimming session? *
A link to an online form will be sent out everyday to confirm that there is no change in symptoms - this must be filled out in order to continue the swimming club as we know it. You must fill in this and submit it no later than 7:00 pm the night before for an early morning session. Failure to submit the form on time will result in the swimmer/s not being able to partake in the next session. We appreciate your understanding in this. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms