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

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

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

I haven’t been in close contact with a Covid-19 patient in the last 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

Email

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

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

I haven’t been in close contact with a Covid-19 patient in the last 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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