Tzofim- Israeli Scouts UK

Covid-19 Health Declaration

How are you feeling today?

Member's First Name

Parent's Phone No during the activity

Member's Last Name

Email

My body temperature is lower than 37.5°C

I am not experiencing the symptoms: fever, continous new cough, sore throat

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

Initials

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!