Guest Registration and Health Declaration Form

Arrival Date:

Guest Name:

Gender:

Contact Details:

Date of Birth:

Email:

Nationality:

Permanent Address:

Coming From (Destination & Route):

Mobile (incase of emergency):

Transportation Mode (on Check Out):

Check Out Date:

Any food allergies or alerts:

Special Occasion:

Travel History:

Traveled abroad in 2020 (Y/N):

Have you Been in contact with people infected/diagnosed with Covid-19? (if Yes, please enter details:):

Do you have any fever? (Y/N):

Do you have any cough? (Y/N):

Do you have any shortness of breath? (Y/N):

Do you have any persistent chest pain? (Y/N):

Signature (Type Full Name):

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