Middleton Cheney FC


Please complete this form for yourself and others in your party as applicable.

Date of Visit*

I confirm that the above named person is not known to have the Covid-19 virus, and is not displaying any of the known symptoms

By entering your personal details and submitting, you are agreeing to our privacy policy

We respect your right to privacy and our obligation to protect your personal data. The information submitted using this form is only retained for 30 days and then destroyed. It will not be passed on or used for any purpose other than Covid-19 contact tracing should it be necessary within the next 30 days.