MCA COVID-19 Health Check Form

Upon attending all MCA classes in person, we are requiring all participants to complete this form UPON ENTRY TO THE GYM to ensure we are minimising risks associated with COVID-19 transmission. Please complete this form honestly for the safety of all of our athletes, staff, and the wider gym community.
Participant Name*
First Last
Contact Number*
- Time in the Gym*
  If attending multiple classes on the same day, please select whichever class you are attending first.
- Approx Entry Time
  
  : Hours
  
  Minutes
  
  AM/PM
- COVID Exposure*
  Are you currently experiencing any symptoms of COVID-19, waiting on a test result, or been exposed to the virus or otherwise told to isolate by a medical or government official?
  - Yes
  - No
Thank you so much for completing this form, we look forward to seeing you for your class soon!

Please note that this submission is valid for one day only, and you will be required to complete this check again the next time you attend a class in person.
One or more response you have provided indicates that it is not safe for you/your

athlete to be attending our in person classes at this time.

The safety of our athletes, staff and wider gym community is of the utmost

importance to us, so we ask that you do not attend your session in person today.

You will be required to complete this form again the next time you attend a class in person, and given that your responses do not indicate any concerns, you will be welcome to partake in your session in the gym then.

We appreciate your patience and understanding at this difficult time.

1/37 Lexton Road, Box Hill North 3129 Victoria, Australia ~ 03 9998 6493

MCA COVID-19 Health Check Form

One or more response you have provided indicates that it is not safe for you/your

athlete to be attending our in person classes at this time.

The safety of our athletes, staff and wider gym community is of the utmost

importance to us, so we ask that you do not attend your session in person today.

You will be required to complete this form again the next time you attend a class in person, and given that your responses do not indicate any concerns, you will be welcome to partake in your session in the gym then.

We appreciate your patience and understanding at this difficult time.