Seashell Active Covid-19 Consent form

PREREQUISITES BEFORE TAKING PART IN A LESIURE SESSION OR ACTIVITY AT SEASHELL TRUST – Data required for track and trace purposes.

 

Self Assessment:

All young people, staff, volunteers and parent and carers must undergo a self-assessment for any Covid-19- symptoms. No-one should leave home to participate in a session if they, or someone they live with, has any of the following:

  • A high temperature (above 37.8°C)
  • A new, continuous cough
  • A loss of, or change to, their sense of smell or taste

This check should be done before each session they attend at the Seashell Trust

Should any individual have demonstrated any such symptoms, they must not participate. Instead they should follow NHS and PHE guidance on self-isolation.

Anyone who has already been instructed to self-isolate by a health care practitioner or PHE should continue to follow this advice and may not participate.

All Participants must do the following:

  1. Complete at register of attendance/booking form or booked before attending each session
  2. Read the Session Risk Assessment provided by Seashell Trust
  3. Complete the Seashell Active  COVID-19 Consent Form

For/participants under the age of 18, a parent/guardian must complete the consent form

Participants only need to do this once however the COVID-19 Risk Assessment will be updated where necessary with the latest Government announcements, therefore they should regularly review and familiarise themselves with the latest risk assessment

All data will be retained until the end of the current academic term. You will be required to complete this information for us at the start of every new academic term, or if you are aware of any changes in your personal circumstances and health status since completing this information.

Please select which session you are attending
Has your child or any member of your household had a new continuous dry cough in the last fourteen days?
Have you or any member of your household had a high temperature (38.7C/100F) in the last fourteen days?
Is there any member of your household who is unwell with symptoms of coronavirus?
Has your child or someone in your household been in contact with anyone who has had a confirmed or suspected case of COVID-19 in the last fourteen days?
Has your child or someone in your household travelled abroad in the last fourteen days? If so please state where
I have read and understood the risk assessment given to me for this event
By completing this form you are consenting to allow your child or yourself to take part in a Seashell Active sessions during the coronavirus pandemic. All parent / guardians/volunteers must have read and understand that sessions have measures in place and accept the risks associated with themselves or the young person booked onto the session Please state the full name of who has completed this form