Mandatory Travel and Health Declaration Form

To protect and safeguard the Anahata Yoga Community , we are asking all Members and guests to complete the following declaration form before entering our studio. Anyone (including airline crew or quarantine exempted person) who has returned or lives with anyone who has returned from overseas must refrain from visiting our studio for 14 days commencing their date of return. 

We give no exceptions to this requirement.

If you have selected “Yes” to any of the questions below or are unable to complete the Declaration form, you will not be allowed to enter the studio premises.

If you have a fever or respiratory symptoms, we advise that you rest at home and/or seek immediate medical attention.

In the event that you should make a false declaration, you acknowledge that you should be liable to indemnify the studio against all losses and damages suffered by the studio or by any other person as a consequence of having made such false declaration.

Mask must be worn at all times except while drinking and showering. The studio reserves the right to turn away any person who does not follow any of the social distancing measures without any refund.

Full Name

Email

Contact Number

Classes(es) you are attending today (please mention each class with the class time)

1.) Have you or anyone you live with, arrived in Hong Kong from overseas in the past 14 days? *

Yes     No

2.) Have you been in close contact with someone who is on Mandatory Home Quarantine from the Centre For Health Protection, or have been issued one? *

Yes     No

3.) Are you currently experiencing fever or respiratory symptoms (cough, sore throat, runny nose, flu, shortness of breath etc.) or have had any such symptoms in the past 14 days? *

Yes     No

4.) Have you been infected with COVID-19? *

Yes     No

  I hereby declare that I have answered the above questions truthfully and to the best of my knowledge.
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