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Home
About Us
Coaches
Ball Mastery
What is Soccer Awareness?
Media
Videos
Gallery
Contact Us
News
Basingstoke
Training
Futsal
Futsal Booking Form
Covid-19 Self-Screen
If you are human, leave this field blank.
Covid-19 Self Screen form
The safety of everyone is our top priority. We will comply with the FA Guidance issued on 24th March 2021: https://www.thefa.com/news/2021/mar/24/fa-guidance-for-return-to-grassroots-football-20210324 This below form needs to be completed by every player and the 1 permitted parent/carer and siblings attending prior to any training session or match. The answers to the questions below must be negative for the participant to take part and for parent/carer/siblings to attend to watch. In order for your child to take part in any session and for any parent/carer/sibling to attend and watch this form must be completed for each person. We cannot accept more than 1 person on any one form. This form needs to be completed by 12 noon of the day of each training session. If you or anyone else develops any COVID – 19 symptoms after 12 noon and having already submitted the form you must not attend. If we do not receive your completed self screen/s by 12 noon on the day of your session please do not bring your child to that evenings session as you will be turned away.
First Name
*
Surname
*
Email
*
A high temperature above 37.8°C
*
Negative
Positive
A new continuous cough
*
Negative
Positive
Shortness of breath
*
Negative
Positive
A sore throat
*
Negative
Positive
Loss of or change in normal sense of taste or smell
*
Negative
Positive
Feeling generally unwell
*
Negative
Positive
Persistent tiredness
*
Negative
Positive
Been in close contact with/living with a suspected or confirmed case of COVID-19 in the previous two weeks
*
Negative
Positive
I have read and I agree to adhere to the player / parent guide and player code of behaviour documents emailed to me
*
I accept the Terms and Conditions
My Child Attends The Following Session (Please Tick)
*
Monday
Tuesday
Friday
Date
*
Submit