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What you'll need to complete this form

Before starting this form, please make sure you have the following information ready:

  • Facility managed by an operating committee
    • The committee Secretary and a representative from each 2020 Winter season "Primary user", need to complete this form together, this can be done by video conference or phone hook-up, if a user group fails to attend and complete they will not be permitted to return to the facility until they do so.
  • Facility managed by an association or club
    • The committee Secretary to complete or fill in at Person 1.
Select facility

Please select the suburb and facility for which your are submitting this declaration.

Governing body guidelines

Tick appropriate box for the person/s completing this checklist that they have read, understood and will implement the guidelines from their governing body:

Submission completed by

Person 1

Person 2

Person 3

Person 4

Continue

Actions

Please indicate your infrastructure actions by checking the applicable checkboxes below.

Must remain closed. Designated club officials may enter individually (1 person at a time).

Must remain closed. Designated club officials may enter individually (1 person at a time).

One person out, one person in. Cleaning requirements as per excerpt from Safe Work Australia.

Must remain closed. Designated club officials may enter individually (1 person at a time).

Must remain closed. Designated club officials may enter individually (1 person at a time).

Must remain closed. Designated club officials may enter individually (1 person at a time).

Must remain closed. No spectators. Tape or barricades to cordon off.

Not to be used. No spectators.

Wipe down with sanitiser.

Lids remain open.

Must remain closed. Designated club officials may enter individually (1 person at a time).

Remain closed and locked. Designated club reps wipe down locks and switches after use.

No congregating of people, tape or cordon off when facility in use if need be.

Tape or barricades to cordon off.

Tape or barricades to cordon off.

Wipe down with sanitiser after handling.

Wipe down net winder with sanitiser after handling.

Provide soap, paper towels, disinfectant wipes, lined bins, process for waste disposal.

PPE, cleaning equipment, printing and laminating can be purchased from facility account.

Submit

Once this form has been submitted, the information you have provided will be directed to the appropriate staff for approval.