Canteen/BBQ Volunteer Declaration

1

Date

2

Shift Start

Hour

Minutes

3

Shift Finish

Hour

Minutes

4

Name

First Name

Last Name

5

Email

example@example.com

6

Phone Number

Area Code

Phone Number

7

Age Group

8

Have you been overseas or in Victoria in the last 14 days or in contact with anyone who has been overseas or in Victoria in the last 14 days?

YESNO

9

Have you recently been in contact with known a Covid 19 case or have you visited any of the affected NSW venues listed at https://www.nsw.gov.au/covid-19/latest-news-and-updates

YESNO

10

Do you have any cold or flu like symptoms?

YESNO

11

Do you have any respiratory symptoms?

YESNO

12

Does anyone in your immediate household currently have cold/flu like symptoms or any respiratory symptoms?

YESNO

13

Please include your current temperature reading as confirmed by your team leader/Kolts Committee Member.

14

Thank you for volunteering with the Kellyville Kolts. If you answered YES to any of the above questions, please inform the team leader/Committee member on duty.

You are unable to volunteer if you answered Yes to any of the above questions. Thank you for your understanding!