Declaration Form for Workshop Students

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

For Students Attending Workshops Conducted at Play Retreat

IMPORTANT NOTICE

Dear student,

Thank you for signing up for a workshop at Play Retreat!

Due to the Covid-19 outbreak, we require all attendees to fill up this declaration form prior to attending the workshop. If you have signed up with/for a friend, please forward this to him/her to fill up as well.

If you have answered YES to any of the questions below, you will not be allowed to join the class. This is to ensure the safety and well-being of our teachers and students. Not to worry, you may reschedule to another class or use the amount paid as credits to purchase resin supplies. We will contact you to make arrangements.

We will also take your temperature before entering the workshop space, and if you are running a fever or display any flu-like symptoms, you will also not be allowed to join the class.

We seek for your cooperation and kind understanding in this matter, and thank you for playing your part to ensure the safety of everyone.

Full Name *

Contact No: *

Which workshop date and time did you sign up for? *

If you are coming with a friend, please indicate your friend's name. *

Have you or your family member (or anyone that stays with you in the same house) travelled outside of Singapore in the past 14 days? *

YES

Have you or your family member (or anyone that stays with you in the same house) been in contact with any COVID-19 affected persons or anyone related to existing cluster cases? *

YES

Are you or your family member (or anyone that stays with you in the same house) currently under Stay Home Notice, Leave of Absence, Quarantine Order or Self-Isolation? *

YES

Are you experiencing any mild flu-like symptoms, such as cough, sore throat, running nose, fever? *

YES

Thank you!

Thank you for taking the time to fill up this form and playing your part to ensure the safety and well-being of everyone. We look forward to having you in our studio soon!

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms