Tzofim UK - Israeli Scouts UK

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This form should be submitted on the day of the activity ONLY!

Geshem Health Declaration

Shevet Halutz & Re'ut Branch Health Declaration

ONE FORM PER MEMBER CHILD

Covid-19 Health Declaration

How is your child feeling today?

Member's Full Name

School Year

Email

My child's body today temperature is lower than 37.5°C

He/She is not experiencing the symptoms: fever, continous new cough, sore throat

His/her Rapid Test today is - NEGATIVE! (when applicable)

Parent's Initials

Date

I declare that the info I’ve provided on behalf of my child is accurate & complete

Thanks for submitting!

BWood

Health Declaration

Israeli Scouts Western Europe

Registered Charity No. 1156815
1 Ballards Lane, London, N3 1LQ
Tel: +44(0)208 371 5285 | E-Mail: info-europe@israelscouts.org

www.israeliscoutseu.org