CLIFTONVILLE ACADEMY CC - COVID 19 QUESTIONNAIRE

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* 1. Please confirm your details

Name:

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* 2. Are you a current member of Cliftonville Academy CC

Yes

No

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* 3. Have you been out of the country (excluding RoI) in the last 14 days

Yes

No

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* 4. Have you displayed any symptoms of Covid 19 in the last 14 days

Yes

No

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* 5. Have you have been around someone with symptoms of COVID-19 in the last 14 days?

Yes

No

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* 6. Are you in a period of self-isolation and/or cocooning under the current HSC (NI) rules?

Yes

No

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* 7. Are you over 70 years of age?

Yes

No

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* 8. Have you read and familiarised yourself with the Cricket Ireland Return to Play Directives?

Yes

No