Shōtō Karate Jutsu

COVID-19 Assessment Form

Before anyone will be allowed to enter the dojo they MUST provide their names and contact details just in case they are required for the NHS track and trace, and answer the Covid-19 risk level questions. .

Please, complete the following contact details form prior to the training session. Also submit updates when ever your contact details and/or Covid-19 risk level change.

First name

Last name

Email address

Phone number

Have you or anyone in your household had COVID-19?

Have you or anyone in your household had any of the following symptoms: dry cough, fever, high temperature, shortness of breath, loss of taste or smell, sore throat?

Have you been in close contact with anyone with confirmed COVID-19 without wearing the appropriate PPE protection?

Have you been outside the UK in the last 14 days?

Are you in the high risk category (clinical extremely vulnerable) as defined by the UK government?

Are you in the moderate risk category (clinical vulnerable) as defined by the UK government?

By completing this COVID-19 assessment form you are agreeing to comply with the SKJ COVID-19 guidelines while outside, entering and inside the dojo (hall). For a hard copy of the form download & print the PDF copy.