Randy Harry COVID Safe Declaration

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

Please complete one declaration per household. This applies to shooting locations for the morning session. If unsure about any questions on this form please email info@randyharry.com.au

We only use these details to provide critical information important for our staff and your guest safety.

Your details will be kept for a 28 day period to provide information if required to NSW Health.

Email *

First Name *

Last Name *

Contact Number *

Are there any at risk members in your household? They could be elderly or have immunocompromised (weak immunity) *

Yes

Has anyone in your household returned from overseas travel (or a cruise ship) in the last 14 days? *

yes

have you visited any known suburbs with high prevalence COVID-19 within Australia in the last 14 days? (hotspots) *

Yes

Maybe

have you had any close contact with a COVID-19 positive case? *

Yes

Do you, or anyone else in your household have any flu-like symptoms? *

Yes

Would you like to request that our photographers wear a mask throughout the day? *

Yes

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Randy Harry Productions. Report Abuse

Forms