CONTACT TRACING

& HEALTH DECLARATION FORM

Please fill out the following contact tracing and health declaration form before entering Mahogany Place Tagaytay.

YOUR TEMPERATURE WILL BE CHECKED ON-SITE.

If your temperature is above 37.5 deg C, you will not be allowed to enter the event venue.

FACE MASKS & FACE SHIELDS are required before entering the premises.

ONLY GUESTS AGE 15-65 will be allowed inside the venue (as per Tagaytay E.O. No. 349). IDs will be checked on-site for age verification.

EVENT DATE (For Walk-in Guests, please choose the DATE TODAY)

First Name

Last Name

Birthday

Age (15-65 ONLY)

Contact Numbers

Are you currently experiencing ANY of the following symptoms? Fever, Sore Throat, Headache, Shortness of Breath?

Yes

I hereby authorize Mahogany Place Tagaytay to collect and process the data indicated herein for the purpose of effecting control of the COVID-19 infection. I understand that my personal information is protected by RA 10173, Data Privacy Act of 2012, and that I am required by RA 11469, Bayanihan to Heal as One Act, to provide truthful information. I declare that I am entering the Mahogany Place Tagaytay premises in my own volition and I will not hold the venue liable for any untoward incident that may occur within the premises or if there should be any incidents of viral infection.