Think Active - 1 Mill Street visitor sign in

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Visitor sign in for anyone visiting Think Active at 1 Mill Street

Name *

Please provide a contact number that we can use to contact you in the event that we become aware of a positive Covid-19 case at 1 Mill Street or within the Think Active team *

Please provide the date of your visit (to Think Active at 1 Mill Street) *

YYYY

Please provide the time you arrived *

Time

Please provide the time you expect to leave

Time

Who are you visiting? *

Vicky Joel

Luke Freer

Hayley Noel

Nat Carroll

Jake Waters

Abi Dixon

Emma Sadula

Sam Davis

Annette Prestidge

Other

I confirm that I am symptom free (Covid-19) *

If you cannot tick yes, please do not visit 1 Mill Street https://docs.google.com/forms/d/117U-0YTHD8UVp2q8XPesLwgANr6JP77WKMcWjwPWjlI/edit#responses

Yes

Required

I confirm a) that no one in my household has had a recent positive test, b) no one in my household is awaiting a test result. c) no one in my household is currently self isolating *

If you cannot tick yes, please do not visit 1 Mill Street https://docs.google.com/forms/d/117U-0YTHD8UVp2q8XPesLwgANr6JP77WKMcWjwPWjlI/edit#responses

Yes, I can confirm these statements

Required

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