Macclesfield Harriers & A.C. Health Questionnaire 2020-2021

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Macclesfield Harriers & A.C. Health Questionnaire 2020-2021 - Road, Trail, Fell

Member Health Questionnaire for ROAD, TRAIL and FELL runners with specific reference to COVID-19 (these questions were not covered on the 2020-21 Membership Form).

Note: T&F have their own COVID-19 processes and health form - speak with your coach for details.

Email *

FIRST Name (of athlete attending training sessions or group runs) *

SURNAME (of athlete attending training sessions or group runs) *

Address *

Telephone Number *

Emergency Contact Name and Telephone Number

Confirm Club Membership (you must be a paid member to attend training sessions and group runs) *

Note: Trial runs before joining the club are also permitted.

YES - I am a fully paid member of Macclesfield Harriers & A.C.

NO - I am not a paid member of Macclesfield Harriers & A.C.

Select the groups you run with (or plan to run with) ... tick all that apply *

B Group

C Group

D Group

E Group

Trail

Fell

Required

List any disabilities or injuries we need to be aware of (or put N/A) *

List any medical conditions we need to be aware of (or put N/A) *

COVID-19 Related questions

Club Road, Trail and Fell runs are considered to be in a COVID-19 secure environment as defined by England Athletics as the runs are outside in the open air. Track & Field training has a specific set of COVID-19 related procedures in place to ensure a COVID-19 secure environment - details on the club website.
.
Athletes MUST NOT attend a session if they or any of their household have any symptoms of COVID-19 or have recently had a positive test.

By attending a session, you (or parent on behalf of U18) are confirming that:

1. Neither I nor any of my household are suffering from COVID-19 symptoms or have recently had a positive test
2. Neither I nor any of my household have travelled to/from a high risk destination in the last 14 days
3. I am not in an NHS high risk category and / or a category specified by the government to self isolate
4. If anything changes regarding my health I will inform the club

If I have attended a group run or training session and subsequently develop symptoms of COVID-19 or have a positive COVID test I will inform the leader/coach of the last session attended, follow government guidelines and not return to training until cleared to do so. If I have a positive test I will also complete the UK Athletics COVID-19 tracking form (see UKA website). The leader/coach will record details of each athlete attending a training session and this will be made available if requested as part of the NHS test and trace programme.

The information provided here will only be used by club officials (including designated COVID-19 Officers) relating to the well-being of club members.

Please confirm that you have read and understood the COVID-19 related statement above by adding your name below.

NOTE: If any of the above information changes it is your responsibility to inform the club and to submit a new form.

I confirm that I have read and understand the COVID-19 related information above (please add your name if over 18 or the name of the parent/guardian if the member is under 18). I will fill in a new form and update the club if any of the above information changes. *

Date of completing this form *

YYYY

Macclesfield Harriers & A.C. - Member Health Questionnaire 2020-2021

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