COVID-19 SAFETY TRAINING DECLARATION FORM Name * Email * Mobile * 1) Have you travelled to Victoria, or overseas, and/or been on cruise ship in the last 14 days? * Yes No 2) Are you currently unwell with any cold or flu like symptoms? (fever, sore throat, runny nose, cough, headache, chills, vomiting, diarrhoea) * Yes No 3) Have you been tested positive for Covid-19 (Coronavirus)? * Yes No If yes, how long ago was that, and have you been re-tested for negative? 4) Have you been in close contact with a positive Covid-19 case / patient? * Yes No 5) Have you had close contact with someone who is unwell, or who has travelled overseas and/or returned from a cruise in the past month? * Yes No 6) Have you downloaded the COVIDSafe App? (not required but encouraged) * Yes No This statement is to declare that I have completed Covid-19 Safety Training provided by The Movement Church, adapted from Department of Health Covid-19 Infection Control training. * Yes No You will receive an acknowledgment of the completion of this COVID SAFETY TRAINING on your email shortly.Thank you for your participation.
