Track & Trace - Wellesbourne Wanderers FC

We are asking all visiting clubs to complete this form before a friendly or league/cup match will be sanctioned by our club. You should collect your own data on your travelling party of coaches, players and parents/carers.

Your Club Name *

Enter Club Name *

Age Group *

Opposition Team Name *

Game Location *

Please enter the name of the location you are playing this match

Your COVID19 Officer Details

Please complete the details of your Club COVID-19 Officer. Rather than asking you for every single player and attendee on this form, it is your responsibility as the visiting team to record this information for 21 days under NHS Test & Trace rules. We will pass your COVID-19 Officers details onto the NHS team if requested.

COVID-19 Officer Name *

COVID-19 Officer Phone Number *

COVID-19 Officer Email *

Date of Game *

Kick off Time *

Attendee Information

Please complete a list of all players, coaches, officials and parent/carer attending the game. Please include the phone number that could potentially be passed onto the NHS Test & Trace service if requested.

Attendees *

	Attendee Name *	Contact Number *	Attendee Type
1

Add Attendee

Code of Behaviour & Health Criteria

By checking the box below, you agree to adhere to The FA’s COVID-19 Code of Behaviour and to the Health Requirements before attending a fixture. It is up to you as the club representative to make your players and parents aware of this guidance. You can read the guidance here.

Confirmation *

Yes I've read the FA COVID-19 document and will pass this onto our parents/players

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