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Your Name (required)
Student(s) Name (required)
Day Attended (required)
No one in my household is currently experiencing the following symptoms (or has experienced them in the last 14 days):
a) Persistent Cough/Shortness of Breath
b) a Fever
c) A loss of taste/smell
No one in my household has travelled outside of the UK within the last 14 days to countries not included in the 'travel corridors' list as currently dictated by the UK government.
To the best of my knowledge, no one in my household has come in to contact with any one displaying COVID-19 symptoms, or someone who has tested positive for COVID-19 within the last 14 days. If someone in the household has been in contact with the above, Test and Trace has confirmed person attending MTA does not need to isolate.
I confirm that the above information is accurate to the best of my knowledge and hereby give consent for the information to be shared with MTA staff. The student(s) for which I am responsible, and I, agree to comply with all hygiene procedures and rules while present on MTA sites and understand failure to follow these directives may result in termination of services provided with no refund.