Self Declaration

Coronavirus Self-Declaration Form

Due to the ongoing and rapidly changing situation with Coronavirus (COVID-19), we are requiring all visitors to CakeArt Creations the Studio premises to fill-out the self-declaration form below. The CakeArt Studio will decide on access to the premises based on the answers provided below.

Each visitor must complete this form. Failure to do so will result in not being able to attend any course and no refund will be given. Please ensure you complete and submit this form 48 hours prior to your course start date. Do not send this form any sooner, as the information provided will not be accurate. If you do not receive an automatic response with 60 minutes of submitting this form, please contact us immediately.

Full Name (required)

Email Address (required)

Contact Number (required)

Course Title (required)

Course Start Date (required)

Do you have any of the following flu-like symptoms:

Fever (38 °C or higher) (required)
YesNo

Cough (required)
YesNo

Breathlessness (required)
YesNo

Sore Throat (required)
YesNo

Loss of taste or smell (required)
YesNo

Please list the country /cities you have traveled to in the last 14 days prior to arrival at CakeArt Creations The Studio.

Place Visited (Please type none if you have not traveled anywhere in the last 14 days) (required)

Date Visited

Place Visited (Please type none if you have not traveled anywhere in the last 14 days) (required)

Date Visited

Place Visited (Please type none if you have not traveled anywhere in the last 14 days) (required)

Date Visited

Have you or any immediate family member come in close contact with a confirmed case of the coronavirus in the last 14 days?

I have been in close contact with a confirmed case of Coronavirus in the last 14 days.
YesNo

This document will be retained confidentially by CakeArt Creations the Studio for one month after submission. The health and wellbeing of our community is our priority therefore CakeArt Creations the Studio reserves the right to deny entry to the premises. (“Close contact” means being at a distance of less than one metre for more than 15 minutes.)

Signature: (Please type full name to act as your online digital signature) (required)

Date Signed: (required)

Private Data Protection Notice:

We are collecting and processing this personal data on the basis of Art. 6 (1) (f) and Art.9 (2) (i) Regulation (EU) 2016/679 (“GDPR”) being necessary for the purpose of the legitimate interests pursued by CakeArt Creations the Studio and necessary for protecting against serious cross-border threats to health. This data will be stored confidentially and is not shared with any third party, unless there will be an official request by the local authorities for reasons of public interest in the area of public health. The datasheet will be deleted one month after collection unless a longer period is required by the public authorities. Thank you for your cooperation.