Covid-19 Contact Tracing As a Sports facility we are required to maintain a register of anyone who uses the club facilities or who visits the club. This is to assist the Ministry of Health’s efforts at contact tracing. If you go to the club or use any of its facilities, you must fill in this form Date* Date Format: DD slash MM slash YYYY Name* First Last Contact Details*Have you entered your contact details into this form before?YesNoContact InformationAddress Street Address City Email PhonePreferably Mobile NumberHEALTH STATUS:*Confirmed free of Symptoms? YesNoContinueTime In*24 hour clock format HH : MM Time Out*24 hour clock format HH : MM Boat Rowed*Other Activity at Club*Any other information?“This information is being collected to assist in the management of the COVID-19 pandemic. It will be given to the Ministry of Health and/or the District Health Board on request in the event that it is required for contact tracing purposes. We will not use it for any other purpose. It will be kept at St Georges Rowing Club. You have a right to access and correct any information we hold about you.”