Learning Journey Education Centre Health Declaration Form
Dear parents, if you have questions or require assistance, please do not hesitate to speak with our centre managers. We seek all parents' cooperation during this period to adhere strictly to the health advisories so as to keep our centres safe for our students.
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Email *
Which centre is your child enrolled in? *
Required
Full Name of Child *
Child's student ID: *
Your child's class day(s): *
Required
Your child's class timing: *
Your child's level *
Name of Parent / Guardian *
Parent / Guardian Contact No. 1 *
Parent / Guardian Contact No. 2
I understand that if my child is unwell (with flu, cough, sore throat, fever), I will not send him/her to classes. I will arrange makeup classes with the managers. *
Which other tuition centres does your child go to, other than Learning Journey? Please indicate name of centre(s) and branch. This is for our internal notification purposes in the event of known COVID19 cases at other centres. *
Has your child been issued Leave of Absence (LOA) or Approved Absence (AA by your child’s school), Stay Home Notice (SHN), or Home Quarantine Order (HQO)? *
If You have chosen maybe / yes, please provide more details in the next question below.
Is your child staying with a household member who is issued with Home Quarantine Order? *
Is your child staying with a household member who is issued with Stay Home Notice? *
My child intend to travel in the near future (eg. between 17 June to 25 July 2020), or have returned from overseas in the past 14 days *
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