2021 Health Declaration Form 健康申報表

本會致力為球員、家長及教練提供健康安全環境。煩請來賓到訪球場時填妥健康申報表。如出現新型冠狀病毒相關症狀、曾與 確診者或剛從外地返港人士有緊密接觸、或剛從外地返港,均絕對不應到訪球場。感謝閣下的配合。

Our Club is committed to providing a safe and healthy environment for our player, parents and coaches. Please complete this form upon your arrival. All visitors, who have any symptoms of COVID-19/ have been in close contact with someone who is a confirmed case or has been out of Hong Kong/ have been out of Hong Kong, are not allowed to enter the pitch. We appreciate your cooperation.

家長/教練填寫 For Parent / Coach

(As printed in identity documents)

球員姓名 Player Full Name

聲明 Declaration and Disclaimer

#緊密接觸可指(其中包括):有直接身體接觸、一同居住或有近距離社交接觸。 # Close contact could mean (among other things): having direct physical contact, living in the same household or having social contact in close proximity.

指引 Instruction

鑑於全球新型冠狀病毒感染疫情近期趨嚴重,為保障大家的安全環境,煩請教練/家長/球員到訪球場前填妥及簽署健康申報表,以申報有關身體 健康狀況及外遊紀錄。本會承諾會保障煩請教練/家長/球員所提供的個人資料及該資料只會用於預防任何傳染病或感染的發生或蔓延之用途。 In the view of the health risks arising from the COVID-19 outbreak, all coaches, parents or players are required to fill in and sign the health declaration form about the personal health conditions and travel history for the sake of maintaining healthy and hygienic environment. Information collected will be kept safely and be solely used for preventing the occurrence or spread of an infectious disease or contamination only.