Our minimum age for new trials is 4

Do you fully accept the risks associated with the training environment in relation to the Covid-19 pandemic?

Have you/your child had confirmed Covid-19 infection or any symptoms (listed below) in keeping with Covid-19 in the last five months? • Fever • New, persistent, dry cough • Shortness of breath • Loss of taste or smell • Diarrhoea or vomiting • Muscle aches not related to sport/training

If ‘Yes’, please provide details: e.g. when did you have symptoms and when did you recover?

Have you/your child had a known exposure to anyone with confirmed or suspected Covid-19 in the last two weeks? (e.g. close contact, household member)

If ‘Yes’, please provide details, e.g. when did they have symptoms and have they recovered?

Do you/your child have any underlying medical conditions? (Examples include: chronic respiratory conditions including asthma; chronic heart, kidney, liver or neurological conditions; diabetes mellitus; a spleen or immune system condition; currently taking medicines that affect your immune system such as steroid tablets)

If ‘Yes’, please provide details. You should consider the increased risk and possibly discuss with your medical practitioner

Do you/your child live with or will you/your child knowingly come in to close contact someone who is currently ‘shielding’ or otherwise medically vulnerable if you return to the training environment?

If ‘Yes’, please provide details:

I/My child am/is attending a trial session having completed the Health Survey above as requested by Bramcote Swimming Club.

I confirm I/my child am/is free from any symptoms related to the Covid-19 virus, I understand the main symptoms include: • a high temperature – this means you feel hot to touch on your chest or back • a new, continuous cough – this means coughing a lot for more than an hour, or three or more coughing episodes in 24 hours • a loss or change to your sense of smell or taste.

I am also confirming anyone from my household taking me/my child to or from the trial session(s) and attending with me is symptom free from the virus.

I confirm that for any future trial sessions and for future training sessions if I/my child join(s) Bramcote SC, I /my child will only attend in the full knowledge that I/my child am/is free from any Covid-19 symptoms. In addition but conversely, confirm by signing this declaration, that if I/my child do/does display any symptoms I/my child will not attend training for a period of at least 10 days and will follow government guidance to self-isolate and get tested for Covid-19.

I attend the swim/artistic swim sessions, including trial sessions session(s), knowing that my/my child's participation cannot be without risk, I am therefore aware of these risks associated with the Covid-19 virus, but still wish to participate in club training.

I understand the processes and protocols Bramcote Swimming Club have put in place in order to reduce risks and I/my child will adhere to these in order to protect my health and the health of other members, staff and other users of the facility. I understand that if I/my child do/does not adhere to these rules/protocols, I/my child will be asked to leave the session

I understand that Bramcote Swimming Club will maintain registers and provide information to NHS Test and Trace in the event of a member contracting Covid-19. I agree for my contact details to be shared with NHS Test and Trace service.

I also understand that the club will have to be flexible and responsive due to the evolving government advice around Covid-19, and the fact that circumstances will change.

I consent to Bramcote Swimming Club collecting and storing the information I have provided as outlined in the Bramcote SC Privacy notice

Please indicate if you would like to come for a taster for swimming, artistic swimming or both