Covid declaration

COVID 19

During these unprecedented times it is important all of us understand and abide by the current Covid regulations.We would ask you then to read and complete the following short form. Acknowledge of this will be a requirement of attending group meetings.
I confirm:

·        that I am aware of the possible risks arising from the health crisis caused by COVID-19 and assume them under my full and exclusive responsibility.

·        that I do not have symptoms compatible with COVID-19 (fever, cough, respiratory distress, malaise, diarrhoea.. ) or any other symptoms of infections.

·        that I am not and have not been COVID-19 positive during the previous 15 days.

·        that I have not been in close contact with anyone confirmed positive or with compatible symptomatology in the previous 15 days.

·        that I have not travelled to high risk countries in the last 15 days.

·        that I undertake any U3A activities at my own risk.

I commit to:

·        respecting the minimum safe distance and using a mask when necessary.

·        informing the Group Leader if I begin to notice symptoms compatible with COVID-19 when with members of the U3A.

·        informing the Group Leader or representative of the U3A if I am diagnosed as COVID-19 positive within 14 days of being in any U3A group. This action is to enable the U3A to take the necessary steps to inform members with whom I may have been in contact.
I confirm I understand the requirements for safe keeping during this pandemic. *

Agree
Name *

First Name Last Name
Email *
example@example.com
Should be Empty:

COVID 19