info@wilderberry.com 0416 148 491

WILDERBERRY

Romantic accommodation in Berry, NSW

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Guest 1

Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

My body temperature is lower than 98.6°F/ 37.5°C

I am not experiencing the symptoms: fever, cough, sore throat

I have checked the NSW Health COVID-19 website and can confirm that I haven’t been in close contact with a Covid-19 patient in the last 14 days

I have not lived in, visited or worked in Greater Sydney, Blue Mountains, Wollongong or Central Coast in the past 14 days

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Date

I declare that the information I’ve provided is accurate & complete

Thanks for submitting!

Guest 2
Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

My body temperature is lower than 98.6°F/ 37.5°C

I am not experiencing the symptoms: fever, cough, sore throat

I have checked the NSW Health COVID-19 website and can confirm that I haven’t been in close contact with a Covid-19 patient in the last 14 days

I have not lived in, worked or visited Greater Sydney, Blue Mountains, Wollongong or Central Coast areas in the past 14 days.

Initials

Date

I declare that the information I’ve provided is accurate & complete

Thanks for submitting!

CONTACT US

info@wilderberry.com

Mob: 0416 148 491 or 0428 658 888

ABN: 68 002 434 077

ADDRESS

Broughton Vale (Berry)

NSW 2535

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WILDERBERRY

Guest 1

Covid-19 Health Declaration

Guest 2
Covid-19 Health Declaration

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Guest 1

Covid-19 Health Declaration

Guest 2 Covid-19 Health Declaration

Guest 2
Covid-19 Health Declaration