SAFRA Toa Payoh COVID-19 Declaration Form
By submitting this form, I consent to the collection, use and disclosure of my personal data below for the purpose of carrying out contact tracing and other response measures in the event of a COVID-19 case.

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* Your Full Name:

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* Contact No:

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* Your Child(ren)/ Grandchild(ren)'s Name, if applicable
(Please separate each name with a comma):

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* Please indicate if you/ your child(ren)/ grandchild(ren):
(ONLY select if applicable)

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* Location of Visit
(please indicate all facilities you intend to visit within the club)

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* .

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