COVID-19 | Kabalebo Nature Resort

HEALTH DECLARATION FORM

Below is a short questionnaire regarding your personal health.

This form must be filled in THREE DAYS prior to departure to Kabalebo Nature Resort.

The information is being collected as part of the public health response to the outbreaks of COVID-19. The information may be used by public health authorities in accordance with applicable national laws of your destination.

If your answer to any of the questions below is “yes”, then boarding is not permitted, based on the local regulations of your destination.

Please note that this form must to be completed for every traveler.

The following questions need to be answered with “yes” or “no”:

Have you recently been in contact with someone infected with COVID-19?

Are you (or the person for whom you complete this form ) currently suspected to have or diagnosed with pneumonia / with the Coronavirus (COVID-19) infection?

Did you (or the person for whom you complete this form) have any of the following symptoms in the past 24 hours?

Fever
Cough
Runny nose
Sore throat
Shortness of breath

If the response to any of the questions above is “yes”, then boarding is not permitted, based on the local regulations of your destination.

PASSENGER INFORMATION

First name
Last name
Date of birth
Country of origin
E-mail address

Flight number (If applicable)

Seat number (If applicable)

Flight date (If applicable)

Any comment

I hereby declare that I have completed everything truthfully;

Date
Time

You will receive a confirmation email later – then print this health declaration and keep it with your travel documents, so that it can be checked at the Zorg en Hoop airport.

If you do not have a printer, you can save the confirmation email and show it on the spot on your smartphone.

Please prove you are human by selecting the Flag.