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Accreditation
admin
2023-01-19T13:37:39+00:00
This form must be completed in order to attend a match at Oriel Park.
First name
*
Last name
Email address
*
Phone
*
What Organisation Are You From ?
*
COVID19 COMPLIANCE
Do you have symptoms of cough, fever, high temperature, sore throat, runny nose, breathlessness, flu like symptoms or loss or change to your sense of smell or taste now or in the past 14 days?
*
YES
NO
Have you been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days?
*
YES
NO
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 metres for more than 15minutes altogether in 1 day)?
*
YES
NO
Have you been advised by a doctor to self-isolate at this time?
*
YES
NO
Have you been advised by a doctor to cocoon at this time?
*
YES
NO
CONTACT PREFERENCES
Preferred contact method ?
*
EMAIL
PHONE
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