Portobello Orchestra Self Certification Form

Please read through the following risk factors associated with attending an orchestral rehearsal. Consider carefully both the risk to yourself and the risks you may pose to other people attending the rehearsal. Then, if you assess yourself fit to attend rehearsals please sign the form. You may want to seek medical advice before you sign.

• Your vaccination status;
• Your personal state of health;
• Other vulnerability factors including age;
• Risks to or from your other household members;
• Risks arising from your workplace or from other social activities you engage in.

Declaration

I have read the above guidance and I assess myself as fit to take part in Portobello orchestra rehearsals, and safe to meet with other members, in a Covid-19 secure environment.