Tzofim- Israeli Scouts UK

ONE FORM PER MEMBER CHILD

How are you feeling today?

Member's Full Name

Parent's Phone No during the activity

Postcode

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

He/she haven’t been in close contact with a Covid-19 patient in the last 14 days

Your Initials

Date

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

Thanks for submitting!

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