COVID-19 DECLARATION FORM

Covid-19 Health Declaration

"We are all responsible"

Full Name

Mobile Number

I am not experiencing the symptoms: fever, cough, sore throat and confirm I have no existing chronic diseases

I have not been in close contact with a Covid-19 patient in the last 14 days

I have not been in contact with anyone who has travelled within the last 21 days

I/my imediate family/my flatmate(s) have not travelled overseas in the last 21 days

Have you done a COVID-19 test? If yes, please mention the date(s) of the test and the result.

I will adhere to PSA's social distancing requirement of maintaining a 2 meter distance from all and be kitted with the mandatory PPE (face mask and/or gloves) as instructed by PSA coaching staff

All the information I have provided is accurate & complete. I agree to inform PSA of any changes in the above information. I have read and agree to PSA's Terms & Conditions as listed on its website including indemnifying PSA, venue owners, facility providers and all related staff from any liability arising directly or indirectly from participating in training activity.

Thanks for submitting!