Junior Online COVID Screening Form Child's Name * First Name Last Name Contact Email * Contact Phone Number * (###) ### #### Date * MM DD YYYY 1. Have you been in contact with a person with or displaying the symptoms of COVID-19 in the last 14 days * Yes No 2. Do you have now, or have you had in the last 48 hours, any of the following symptoms * Please circle any that apply Cough Fever Shortness of breath Excessive fatigue tiredness Sore throat None of the above 3. If you have been outside of the country in the last 14 days, please confirm that you have adhered to all applicable Dept. of Foreign Affairs guidelines * Yes No N/A 4. If any of the above changes you agree to contact the Club and withdraw from coaching with immediate effect. * Yes No I, the undersigned, accept and support the measures by Monkstown Tennis Club as a means to try and prevent the spread of COVID-19 amongst players and support personnel. I have completed this form truthfully and accept willingly that as a result of my responses above that Monkstown Tennis Club, in accordance with its current procedures, may deny me entry to the Club for a period of time. Name First Name Last Name Date MM DD YYYY Further to the outbreak of COVID -19 (Coronavirus), Monkstown Tennis Club is adhering to guidance from Tennis Ireland and the Department of Transport Tourism and Sport Expert Group in an effort to contain the spread of the Covid-19 virus and ensuring a safe environment for players and staff. This screening procedure is one of our measures seeking to identify any potential cases at the earliest opportunity in order to avoid any contacts/spread. The research to date for this novel virus suggests that transmission appears to be during symptomatic phase. Hence identifying those with symptoms and isolating should reduce risk significantly. In addition, this screening complements our general illness precautions which is to avoid contacts when ill. Thanks for filling in the Covid form.Judy Helen LaneMay 3, 2021 Facebook0 Twitter 0 Likes
