Swim Intensive Week

Name *

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Last

Email *

Email:

Phone

Question 1: Are you a close contact of a person who is a confirmed or suspected case of COVID-19 in the past 14 days (i.e. less than 2 meters for more than 15 minutes accumulative in 1 day) *

No.

Question 2: Do you have symptoms of cough, fever, high temperature, sore throat, runny nose, breathlessness, or flu like symptoms now or in the past 14 Days. *

No.

Question 3: Have you been advised by a doctor to cocoon at this time. *

No.

Question 4: Have you been advised by a doctor to self isolate at this time? *

No.

Question 5: Have you been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days. *

No.

Question 6: Do you have any other circumstances relating to COVID-19, not included in the above, which may be applicable at this time . If your situation changes after submission of this form please contact management. *

No.

Covid-19 Declaration *

I agree that I have fully read and understand the above questions.

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

Your privacy is very important to us. Cavan Leisure will protect your privacy and not disclose your information to third parties. We want to make your experience on the Internet as enjoyable and rewarding as possible with complete confidence.

Cavan Leisure Centre

Phone: 049 436 2888

Swim Intensive Week

COVID-19