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Return to Play Form

Return to Play Form

By HXFC September 15, 2020 April 28th, 2021 Headline, Uncategorized

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All HCYFC groups will be returning to training from the 26th April .

As part of the Covid 19 compliance plan, a parent of every child who wishes to attend training must complete a “Return to Play” from.

Please complete the form as soon as possible.

Your Name *

First

Last

Your Childs Name *

First

Last

Mobile Number

Email *

Do you or your child currently have or have you been diagnosed as having COVID-19 in the last 14 days?

Yes
No

Have you or your child displayed any of the COVID-19 symptoms in the last 14 days such as fever, shortness of breath or loss of taste and smell?

Yes
No

Are you or your child experiencing any fever-like/Temperature symptoms

Yes
No

Do you live in the same household as someone, or have been in close contact with someone (i.e, less than 2 meters for more than 15mins accumulative in 1 day) who has displayed the symptoms of COVID-19 in the last 14 days or who is a confirmed case of COVID-19?

Yes
No

Is a member of your household self-isolating?

Yes
No

Are you in a period of self-isolation under the current HSE Guidelines?

Yes
No

Do you have any of the underlying health conditions listed below? • Cardiovascular Problems • High Blood Pressure • Diabetes • Chronic Kidney or liver disease • Compromised immunity diseases • Obesity (BMI40+)

Yes
No

Have you visited any countries outside the island of Ireland in the last 14 days?

Yes
No

If you have answered “YES” to any of the questions above or have indicated to us that you have symptoms of COVID-19 you MUST NOT attend any club activity and are advised to seek professional medical help/assistance.

I have read and understood the FAI "Safer Return to Training" protocols - https://www.fai.ie/domestic/news/fai-safer-return-to-play-protocol

Yes

I give my consent to allow my child to train with Harolds's Cross YFC on the premises of Harold's Cross YFC

Yes

Name

HXFC

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Email: info@haroldscrossboys.ie
Rosary Park
350 Harolds Cross Road
Dublin 6W
D6W VY70

Home
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Contact Us
- Club Directory
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Email: info@haroldscrossboys.ie

Rosary Park350 Harolds Cross Road
Dublin 6W
D6W VY70