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aj.dodd@btinternet.com

07789 275870

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Pre lessonCOVID-19 Declaration

How are you feeling today?

First Name

Last Name

Email

I am not exhibiting any COVID-19 symptoms and have not done so for at least the last 7 days

I have not tested positive for COVID-19 within the last 14 days

I haven’t been in close contact with anyone exhibiting Covid-19 symptoms in the last 14 days

I will follow all instructions and best practice surrounding cleanliness in the car before, during and after any lessons

Date

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

Thanks for submitting!

aj.dodd@btinternet.com

07789 275870

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