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Goju Ryu
Karate Centre

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Covid-19 Health Declaration

How are you feeling today? Do you feel healthy enough to train?

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, headache, loss of smell or body pain

I haven’t been in close contact with a Covid-19 patient in the last 14 days

Initials

Date

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

Thanks for submitting!

Monday to Thursday: 16:00 - 20:00

Saturdays: 07:00 - 12:00

Sundays & public holidays: closed

Dojo admin:

Zoe Jagger-Hinis

dojo@grkc1978.com
Cell: 083 263 6134

480 Ontdekkers Road
Florida Hills, Johannesburg

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