Return to Rugby COVID 19 Health Declaration Form

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Return to Rugby COVID 19 Health Declaration Form - Larne RFC Minis

Please fill out all areas (where Possible). Once completed this form will act as a legal document.

Name of child (To be completed-First and Surname) *

Which year group are you training with? *

Date of training Session you are attending? *

YYYY

Name of Parent/Gaurdian? *

Contact number for parent/gaurdian during session? *

IF YOU HAVE ANY OF THESE SYMPTOMS, YOU SHOULD SELF-ISOLATE AND CONTACT YOUR GP. PEOPLE IN YOUR HOUSEHOLD WILL NEED TO RESTRICT THEIR MOVEMENTS

I confirm that I/My child are well and, to the best of my knowledge, have no current symptoms of COVID-19. If I begin to feel unwell, or develop symptoms of COVID-19, I will not attend any upcoming training session/match without first consulting my COVID-19 Club Compliance Officer. *

I confirm the above statement

Required

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