DELGADO TENNIS ACTIVITY DECLARATION FORM

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With immediate effect, every tennis player attending Braywick Leisure Centre is to complete a form prior to each visit.

You must answer “NO” to all questions in order to participate in Delgado tennnis sessions at Braywick Leisure Centre.

If you answer “YES” to any of the questions, please DO NOT travel to the Sports Centre.

If you experience any symptoms or answer “YES” to any of these questions, immediately contact your health care professional for recommended next steps AND notify Living Tennis.

Please proceed >>>>>>>>>>>>>>>>>>>>>>>>>>
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1. Have you had any of the following symptoms in the last 24 hours?If the answer is yes to any of these statements tick those that apply to you. Please scroll through to see all options.
Cough
Shortness of breath or difficulty breathing
Fever (usually 100.4 or higher)
Chills
Repeated shaking with chills
Muscle pain
Headache
Sore throat
Loss of taste or smell
I don't have any of the above symptoms
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Please DO NOT travel to Braywick Leisure Centre if you have a cough and or shortness of breath or difficulty breathing.

OR

Please DO NOT travel to Braywick Leisure Centre if you have at least 2 of the following symptoms:-

Fever (usually 38c or higher)

Chills

Repeated shaking with chills

Muscle pain

Headache

Sore throat

Loss of taste or smell

You should do the following:

Self-quarantine for at least 10 days from the date on which you first experienced any symptoms

Wait until you have had no fever for at least 3 days (without the use of fever-reducing medication)

Wait until respiratory symptoms have improved (no cough and or shortness of breath)

Please proceed to register your absence >>>>>>>>
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2. In the last 14 days have you:* This field is required.If the answer is yes to any of these statements tick those that apply to you.
Been in contact with someone diagnosed with Covid-19?
Been in close contact with someone who displayed Covid-19 symptoms?
Travelled internationally or taken a cruise?
Spent time in a local lock down area?
None of the above apply
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If you answered “Yes” to any part of question two, please DO NOT make the journey to Braywick Leisure Centre. You should self quarantine for at least 14 days.

Please proceed to register your absence >>>>>>>>
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I confirm at the time of completing this form I am symptom free, have not returned from a country that requires me to quarantine, been in contact with anyone who has tested positive recently, nor visited a lockdown area recently. Should this change I will refrain from visiting Braywick Leisure Centre and inform Living Tennis.

Player: First Name Last Name Date

Phone Number
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Signature
Clear
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Please notify Living Tennis of your absence by completing this form:-

I confirm I am unable to attend Delgado Tennis activities at Braywick Leisure Centre.

Based on guidelines my expected return to Braywick Leisure Centre: Return Date .
Self Isolate if symptomatic for 10 days from symptoms presenting (you must be free from a fever and or cough and shortness of breath for at least three days before returning)
Self isolate for those in contact with persons tested positive or in a lock-down area - 14 days from first contact.

Player: First Name Last Name

Email
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Should be Empty: