M2M CovidSafe Declaration

M2M CovidSafe Declaration

Copy of the Rider & Support Crew CovidSafe Declaration

 

Rider & Support Crew Covid – 19 Declaration

Must be completed less than 24 Hours before the event.

 

Team Captains MUST return all Declarations to the Ride Director before the Start of the Event or at the Friday Night Briefing !

By signing this declaration, you are acknowledging that:

  • You have NOT tested positive to Covid-19 in the last 30 days.
  • You haveNOT travelled to or from overseas or a designated (DHHS) Hot Spot in the past 30 days.
  • You areNOT unwell or displaying any Covid-19 or flu-like symptoms.
  • Cough
  • Fever
  • Sore Throat
  • Shortness of Breath
  • Runny Nose
  • Loss of sense of smell or Taste
  • You are NOT currently required to be in isolation because you are awaiting Covid-19 test results or have been diagnosed with Covid-19.
  • You areNOT identified as being a close contact (Indicated by DHHS) to someone who is a confirmed Covid-19 case.

IF YOU CANNOT MEET THE ABOVE CRITERIA PLEASE LET YOUR TEAM CAPTAIN KNOW AND WITHDRAW FROM THE 2021 MURRAY TO MOYNE CYCLE RELAY.

Thankyou for helping to keep the M2M participants and volunteers safe.

 

(Print your Full Name)________________________________________________________

(Print your Full Address)______________________________________________________

__________________________________________________________________________

Mobile Contact No:__________________________________________________________

M2M Team Name:___________________________________________________________

M2M Team No:_________________________ Date:_______________________________