MATCHDAY DECLARATION OF COVID-19 STATUS

Fixture:
Venue:​ Burroughs Park, Great Wakering, Essex
Date: ​

I can confirm that all players and staff not limited to:
Coaching Staff, Medical Staff, Kit Staff and other Club Officials and Staff, who have been given access to the ground, have:
• Answered negatively to having any symptoms that could be related to Covid-19, including a high temperature, new continuous cough or loss of smell or taste
• Not had a positive Covid-19 test in the past 14 days,
• Had a temperature check at less than 37.6°C today,

We have ___ players and __ staff who have been given access to the ground today.

Signed on behalf of White Ensign Football Club

Name:

Position:

Date:

Signature: