3K1C Newcastle

Scouts

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How are you feeling today?

First Name

Last Name

Section attending

This person's body temperature is lower than 98.6°F/ 37.5°C

This person is not experiencing the symptoms: fever, cough, sore throat, shortness of breath, loss of sense of smell?

This person hasn’t been in close contact with a Covid-19 patient in the last 14 days

Parent/Guardian email

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

3rd Kildare 1st Celbridge Scout Group

3K1C Newcastle

Main Street

Newcastle

Co. Dublin

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