Your company - Covid19 Consent Form

Name of Child *

Date of Birth *

Telephone *

Email *

Have you or your child returned from any of the countries currently listed on the governments quarantine list in the past 14 days *

Has your child or anyone within your household has any of the following symptoms : ........A TEMPERATURE OF 37.8 OR ABOVE. A COUGH/ SHORTNESS OF BREATH/ LOSS OF TASTE OR SMELL *

Please provide us with details of any health problems or allergies that your child has *

Have you or your child been in contact with anyone with Covid - 19 symptoms *

* required fields

Covid - 19Consent Form

Covid - 19
Consent Form