Health Declaration

Please fill out the following form
in order to participate in our race.

Section A: Tick boxes if YES
Section B: Have you been exposed to someone diagnosed with Covid-19 or had recent contact with someone who is self-isolating whilst waiting for a Covid-19 test result?
Have you been in quarantine / self-isolation for the past 14 days?
Section C: Do you suffer from any pre-existing medical condition / chronic illness that may have compromised your immune system, i.e. respiratory disease, diabetes, heart disease, or any other chronic illness that could compromise one’s immune system?
Are you 65 years of age or older?
  • If any symptoms mentioned in questions A1 to A10 are experienced, then:

  • Do not attempt to enter BERG 100 event.

  • Consult your Healthcare Worker to find out if testing / self-quarantine will be necessary.

  • You may only start Berg 100 race if you have been cleared by your Healthcare Worker.

  • If you experience any symptoms mentioned in questions A1 to A10 then this does not mean that you have Covid-19. This screening questionnaire is used as precautionary indicator to establish whether you should be quarantined and if tests are required to make a definite diagnosis.

  • If you answered “YES” to any of the questions in B1, B2, C1 and C2 (but have none of the symptoms mentioned in A1 to A10), then this does not mean that you will not be permitted entry into berg 100 race (a decision may be necessary whether your response requires any further intervention).

  • If you are tested positive for Covid-19 isolate for 14 days. Follow your Healthcare Worker’s advice.

Thanks for submitting!