UL Sport Self Declaration Form I confirm Question Title * 1. That I have not visited any countries outside of Ireland within 14 days of my visit to UL Sport Yes No Question Title * 2. That I am not suffering any COVID-19 / flu like symptoms such as cough, fever, high temperature, sore throat, runny nose, breathlessness, or flu like symptoms now or in the past 14 days Yes No Question Title * 3. That I have not been diagnosed with or been in the company of someone with COVID-19 in the past 14 days Yes No Question Title * 4. That i will notify UL Sport if I begin to show any COVID-19 symptoms within 14 days of my booking Yes No Question Title * 5. That I will follow the posted UL Sport COVID-19 instructions for using the facilities Yes No Question Title * 6. Which UL Sport facility will you be using Gym Swimming Pool Climbing Wall Sports Hall Outdoor Facilities Group Fitness Exercise UL Sport Adventure Centre UL Sport Boathouse Strength & Conditioning Room Personal Training Question Title * 7. Contact Details Full Name Email Address Contact Number UL Sport Membership / Contact ID No. Question Title * 8. When do you plan to start using the facilities Date / Time Date Question Title * 9. Disclaimer I understand that all exercise carries some risk of injury. I declare myself in good health and I take full responsibility for my participation in fitness programmes at UL Sport and I will inform UL Sport and/or the instructor of any medical or physical conditions which may have relevance to the exercise being undertaken. Yes No Submit
