North Cork Sports & Recreation CDYS Covid

North Cork Sports & Recreation LTI - Cloyne Diocesan Youth Services

Covid - 19 Health Assessment
It is expected that all learners are following the current government covid-19 guidelines. Failure to do so will see your place on the course reviewed.

This Form MUST be completed by All Individuals who are attending any group within CDYS. IF you are attending several Groups within the week you will need to complete this form for EACH group. The form must be submitted 12-24 hour's before the group commences.

Failure to complete this form before attending will result in you not being able to gain access to any CDYS facility.
Name*

First NameLast Name
1. Do you have symptoms of cough, fever, high temperature (Higher than 37.5), sore throat, runny nose, breathlessness or flu like symptoms now or in the past few days? *
2. Have you been diagnosed with confirmed or suspected COVID-19 infection in the last number of days? *
3. Are you a close contact of a person who is a confirmed or suspected case of COVID-19 in the past number of days? *
Number of days is dependent on your vaccination/booster status
4. Have you been advised by a doctor to self-isolate at this time? *
5. Has anyone in your household travelled recently from abroad?*
6. Are you following current government guidelines regarding Covid 19?*
If you answered yes to questions 1 to 5 or no to question 6 you must self-isolate and contact your gp.

You must not attend any CDYS facility.
Should be Empty:

North Cork Sports & Recreation LTI - Cloyne Diocesan Youth Services