Precautionary COVID-19 Liability Release

I, *

please add name

First Name

Last Name

....agree to the following: *

Please read all statements and then confirm below.

I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days.

I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the last 30 days.

I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 within the last 30 days.

I affirm that I, as well as all household members, have not traveled to any Country or city outside of our own that is or has been considered a “hot spot” or is in the Red or Amber lists, for COVID-19 infections within the last 30 days.

I understand that Imaginate Creative Ltd cannot be held liable for any exposure to the virus or any other contagion caused by misinformation on this form or the health history provided by each client or visitor.

I affirm that I, as well as all household members are not currently waiting for the results of a PCR test.

Please tick to confirm *

I agree to the above statements

Date *

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Date of visit *

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