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COVID 19 DATABASE HEALTH DECLARATION

OR CALL US ON:

02 4862 5988

Health Declaration

Please fill out the following health declaration form in order to participate in our activity. Submissions are valid up to 24 hours prior to the activity.

First Name

Last Name

Email

Enter a number

Are you experiencing any flu symptoms?

No

Yes

Date

Initials

I confirm that the information given in this form is true

Thanks for submitting!

PLEASE CONTACT US TO MAKE AN ENQUIRY & BOOKING

GRAZIE!

Thank you for contacting Eccetera Trattoria & Pizzeria, we will get back to you shortly re your enquiry.

© 2016 by Eccetera Trattoria & Pizzeria

2/6 Boolwey st, Bowral NSW 2576

T: (02) 4862 5988

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