Hash No 927: Travel Declaration Form

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Hash No 927: 29th of March, 2020

Respect: In line with Singapore Guidance, and as a precautionary measure to reduce the risk of exposure to Covid-19, protect our community and make sure that none of us is taken off by a person in a hazmat suit to the NCID in an ambulance and police escort as a suspected case, our community would be grateful if each of us completes the following Declaration Form.

On Back: Once this form is completed you will then receive the full details of Hash No 927 via email, we will not be posting Hash details publically as part of this containment mechanism.

Email *

Last Name *

First Name *

NRIC *

Mobile Number *

Has anyone in your household, or anyone you may be bringing to the Hash travelled outside Singapore within the last 14 days? *

Yes (You will not be able to participate in this Hash)

Have you, anyone in your household or anyone you may be bringing to the Hash knowingly had any contact with either a suspected case of Covid-19 or a person issued with any type of Quarantine Order in the last 14 days? *

Yes (You will not be able to participate in this Hash)

Dietary restrictions *

None

Vegetarian

Vegan

Kosher

Other:

How many of you will be coming to the Hash this Sunday *

I declare that the information provided is correct and accurate for all people coming with me to the Hash. By submitting this form I agree to abide by our Hash's viral outbreak guidance. *

Yes

A copy of your responses will be emailed to the address you provided.

Submit

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