Track and Trace Forms

I can confirm that I have read and agree to the safe practices during our sessions at Goytre.

Branching Out Learning Health Declaration

Please fill out the following health declaration form on behalf of you and your family members in order to participate in our outdoor session. Do not complete any earlier than 24 hours prior to each of our sessions at Goytre.

First Name

Last Name

Are you or any of your household members experiencing any Covid-19 symptoms (including temperature, continuous cough, loss of sense of smell or taste?)

Yes

Have you, or any of your household member tested positive for Covid-19 or returned from a country or area currently on the govt quarantine list within the last two weeks?

Yes

Date

Initials

I can confirm that we are not displaying any symptoms of Covid-19 and feel well and able to attend the session at Goytre.

Thanks for submitting!

Branching Out Learning Covid-19

Track and Trace Form

Please complete and submit before attending our first session at Goytre.

Branching Out Learning Health Declaration

Please fill out the following health declaration form on behalf of you and your family members in order to participate in our outdoor session. Do not complete any earlier than 24 hours prior to each of our sessions at Goytre.