Could please read this class consent form prior to attending class and advise me immediately if you have any questions or problems.
The following method statement of practices is designed to minimise risk of catching and spreading the Covid-19 Virus in the context of our classes.
All classes are pre-booked. Class numbers are limited; this to allow for the 2 metre indoor distancing guideline. Spaces are marked in the hall.
Please arrive ten minutes before class and wait in your car or at a socially distanced outdoor place.
I will then collect your completed Method Statement (this is only on your first class).
At 9am I will guide you into the Community Hall.
- Do not present yourself to class if you have:
Shortness of Breath
Loss of Sense of Taste or Smell
- Please arrive on your own or in ‘safe’ groups such as those you share a residence with i.e. family members.
- Access will be via the main doors to the Rugby Club. Door will be open. Please do not shut the door.
- Present yourself to class with an appropriate mouth covering in place.
- You will enter the room and take your space and stay seated on your mat until class commences.
- Clean your mat before each class.
- Please bring only essentials to class.
- The room will be ventilated to allow free air flow; wear appropriate layering to allow for this.
- Please bring your Loyalty Card (should you have one) self-certified to class. Payments only via BACS.
- Bring your own mat and only use that mat.
- Maintain appropriate distancing at all times.
- Toilet facilities will not be available.
- Please leave class in an orderly fashion via the back of the hall.
Consent for Classes During COVID-19 Pandemic
I ______________________ (class member name) understand that I am participating in a group class.
I understand that the novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organisation and that COVID-19 is extremely contagious and is believed to spread by person-to-person contact; and, as a result, social distancing is mandatory. I understand that the actions of others is not entirely possible to contain, however, I am satisfied that the Method Statement measures are in place to minimise risk as much as possible ______ (initials)
I understand that Carol Westmorland, class teacher, is closely monitoring the COVID-19 situation and has put in place reasonable preventative measures aimed to reduce the spread of COVID-19. However, given the nature of the virus, I understand there is an inherent risk of becoming infected with COVID-19 by virtue of taking part in a group class. I hereby acknowledge and assume the risk of becoming infected with COVID-19 in a class environment, and I give my express permission to proceed _____ (initials)
I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. I understand that COVID-19 can cause additional health risks, some of which may not currently be known at this time _____ (initials)
I confirm that I am not presenting with any of the following symptoms of COVOID-19 listed below:
· Shortness of Breath
· Loss of Sense of Taste or Smell
· Dry Cough
· Runny Nose
· Sore Throat
I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. I confirm that I have not travelled in the past 14 days ________ (initials)
I confirm that if I develop COVID-19 symptoms following class or a known contact of mine develops symptoms, I will immediately inform the class teacher to enable appropriate measures to be put in place and contact tracing to commence _____ (initials)
Class member name ……………………………………
Contact: T: 01768 896 733 | M: 07976 266 335 | E: firstname.lastname@example.org
© 2017 Carol Westmorland and Pilates Cumbria