Health Waiver | ONE DAY STUDIOS

Covid-19 Health Declaration

Please complete this before attending the studio in-person!

Form is valid for 24 hours after completion, and is required for each attendance.

First Name

Last Name

My body temperature is lower than 37.5°C

I am not experiencing the symptoms: fever, cough, sore throat, runny nose, loss of smell or taste

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

I have received two doses of either AstraZeneca, Pfizer, or Moderna vaccine, OR I have a lawful health exemption that prevents me from being vaccinated at this stage.

Full Name

Date

I declare that the info I’ve provided is accurate & complete. I understand I will need to provide evidence of my vaccination status or my lawful health exemption when I arrive. If I do not provide this, I may be refused entry.

Thanks for submitting!

warrnambool

Covid-19 Health Declaration

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