If you have any other symptoms (no matter how mild) which may be connected to another virus or bacterial infection please allow 48 hours after symptoms have gone before returning to work in order to protect all swimmers and staff.
SIGNATURE PAGE FOR STAFF:
For staff under 18 – parents should complete the form above and tick the boxes below and sign:
6. I understand that it is my responsibility to inform the Lead Covid Officers if my answers to any of the Health Questions change after I have submitted the form and that I should NOT attend work until I have permission from the Lead Covid Officers.
7. I have checked that my mobile / emergency contact details are up to date on TeamUnify or if I do not have access to TeamUnify I have given them on this form:
8. I have read the protocols and procedures and risk assessment and viewed the video sent by the Lead Covid Officers explaining the protocols that need to be followed on returning to work. (If you have any questions about the protocols please ensure that these are cleared up before signing this form):
9. I understand I will be given by own bag of PPE. I also understand that at the time of writing face masks are not compulsory, but should I wish to wear a face mask during the sessions I may do so. I agree that should face masks become compulsory I will wear a face mask at work.
10. I agree that if government, Swim England or any other relevant guidance changes I will adopt/follow that guidance as directed by Guildford City Swimming Club.
11. I understand and agree that if in the view of the Lead Covid Officer I intentionally break any of the social distancing measures put in place to safeguard swimmers/staff I will be suspended and a review of my employment will take place.
12. I confirm I am happy to return to work, but also agree that depending on the needs of the Club, I may continue to be furloughed or flexibly furloughed as necessary.
Please note, if you have ticked YES to questions 1 – 4 or NO to questions 5 to 11 on this document you must not return to work until the Lead Covid Officers have cleared you for work.
STAFF MEMBER’S FULL NAME*:
STAFF MEMBER’S MOBILE NUMBER INCLUDING UNDER 18s*:
STAFF MEMBER’S EMAIL ADDRESS*: Parent’s email address if under 18
STAFF MEMBER’S ADDRESS*:
SIGNED*: If under 18 Parent’s Signature is Required:
EMERGENCY BACK UP MOBILE FOR STAFF MEMBER*: If under 18 this should be a parent
EMERGENCY CONTACT NAME*: Add relationship to staff member
PARENT’S FULL NAME (if applicable):
If you have any questions regarding this form etc please contact the Lead Covid Officer’s at firstname.lastname@example.org.
Please prove you are human