Health Declaration - Trial Swimmers & Divers
This is a mandatory form.

Prior to your trial session, please read through all the documentation on our COVID website page.

https://maidstoneswimmingclub.co.uk/about/covid-corner

For those under the age of 18, parents/guardians should complete the health check and tick the boxes on behalf of their triallist. By sending this form, they are confirming that the questions have been answered in relation to their triallist and that they have read or understands the protocols and procedures that have been put in place and the risks involved.

If you have any questions regarding this form, please email covid.maidstonesc@gmail.com.
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Swimmer/Diver's Full Name *
Parent/Guardian's Full Name *
Q1. Have you had a confirmed COVID infection or any symptoms (fever • new, persistent, dry cough • shortness of breath • loss of taste or smell • diarrhoea or vomiting • muscle aches not related to sport or training) in keeping with COVID in the last three months? *
If yes, please provide details.
Q2. Have you had a known exposure to anyone with confirmed or suspected COVID in the last two weeks? (e.g. close contact, household member) *
If yes, please provide details.
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