CherryHill (PYO) COVID-19 Check In

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Name*
Health Declaration - Part 1*
BY AGREEING TO THIS HEALTH DECLARATION, YOU ARE CONFIRMING THAT YOU OR YOUR DEPENDENTS DO NOT PRESENT WITH ANY OF THE BELOW SYMPTOMS: Fever • Cough • Shortness of breath
Health Declaration - Part 2*
BY AGREEING TO THIS HEALTH DECLARATION, YOU ARE CONFIRMING THAT YOU OR YOUR DEPENDENTS HAVE NOT: Recently been in contact with someone diagnosed with Coronavirus to your knowledge, and have not traveled outside Australia in the last 2 weeks.