Harlech Triathlon Club Health Questionnaire and Covid Declaration Question Title * 1. Full name Question Title * 2. Do you have any medical conditions or disabilities that may affect your ability to participate in club training sessions? Yes No Question Title * 3. Have you recently suffered any form of injury? Yes No If you answer yes to either of the two questions above, please confirm that you are able to participate in club activities. If you are unsure, you should seek medical advice from your GP. Question Title * 4. Please confirm that you are aware of the COVID-19 symptoms (listed below) · Fever· Persistent, dry cough· Loss of taste or smell I am aware of the symptoms of COVID-19. Question Title * 5. Please confirm that you understand the NHS advice if you experience any of the symptoms listed above. I understand that I should get a coronavirus test as soon as possible. Whilst waiting for test results I must self-isolate. Question Title * 6. Please confirm that you understand the action required if you have a known exposure to anyone with confirmed or suspected COVID-19 in the last two weeks. I understand that I must self-isolate for 14 days in these circumstances. Question Title * 7. Please confirm that you understand the requirements for social distancing when participating in club training sessions. I understand that I must maintain the 2m social distancing rules in line with Welsh Government Regulations. Question Title * 8. Please confirm that you understand the requirements for social distancing on arrival/leaving and post training. I understand that before and after activities I must maintain government mandated social distancing for social interaction. This includes in any available changing rooms, showers and or other facilities in which participants congregate in afterwards. To limit the time spent congregating at a venue before activity begins I will arrive changed and ready to begin the warm-up where possible, minimising time spent waiting or in changing rooms. Question Title * 9. Signed: Enter your full name(Over 16 signatures only, a parent or guardian must sign on behalf of juniors) Question Title * 10. Date DD/MM/YYYY Date Submit