COVID-19

COVID-19 CLEARANCE FORM

PLEASE COMPLETE AND SUBMIT BEFORE EACH RUNNING SESSION. Complete and submit this Covid-19 Clearance Form on the day of each running session before your session time. Failure to do so will result in you being unable to attend the relevant session on that particular day.

Name
Course Type & Location
Address
Do you have symptoms of cough, fever, high temperature, sore throat, breathlessness or flu like symptoms now or in the past 14 days?*
- Yes
- No
Have you been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days?*
- Yes
- No
Are you a close contact of a person who is a confirmed or suspected case of COVID-19 in the past 14 days?*
- Yes
- No
If your situation changes after you complete and submit this form you agree to inform your running coach*
- Yes
- No
Please enter any other information you feel is relevant.
By ticking this box, I acknowledge that the information that I have given is accurate and complete.*
- Yes
Date
DD slash MM slash YYYY

COVID-19

COVID-19 CLEARANCE FORM

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