Slough RFC KIDS FIRST COVID 19 Self Screening Test and Trace form
This form must be completed before participating in any Slough RFC KIDS FIRST session.
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Please answer the below for your child and accompanying adult. *
yes
No
Do you have a high temperature (this means you feel hot to touch on your chest or back- you do not need to measure your temperature)?
Do you have a new, continuous cough?
Do you have a loss or change in sense of taste or smell?
Do you have an unusual shortness of breath during exercise or rest?
Are you currently isolating after testing positive for COVID 19?
Are you currently isolating as a result of showing symptoms of COVID 19?
Are you required to isolate or quarantine following overseas travel?
Are you isolating due to living in the same household as someone with Covid-19 symptoms, or with someone who has tested positive for Covid-19?
Are you currently isolating after being classed as a 'contact' by NHS test and trace?
Have you been asked to isolate by another organisation- eg. school?
I understand that if I have answered yes to any of the above questions, my child should not attend Slough Rugby Club and we should follow the test and trace information below. *
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Required
Player's name? *
Age group? *
Contact number of accompanying adult- *
Date attending Slough Rugby Club- *
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