_______________________________________
Jerusalem Cake Design Health Declaration
Student Name:______________
Student Teudat Zehut:_________
We certify that:
we measured the temperature, and the body temperature is under 38 degrees celsius.
The student doesn’t have a cough and does not have breathing difficulties or loss of taste or smell.
To the best of our knowledge, the student has had no known exposure to someone sick with the Coronavirus.
Parental Signature:__________
Date:____________
Photo permission:
I give permission for photos of my son/daughter to be used on the JCD instagram stories or other JCD promotional material. YES | NO
_____________________________________(cut here)
Jerusalem Cake Design Health Declaration
Student Name:______________
Student Teudat Zehut:_________
We certify that:
we measured the temperature, and the body temperature is under 38 degrees celsius.
The student doesn’t have a cough and does not have breathing difficulties or loss of taste or smell.
To the best of our knowledge, the student has had no known exposure to someone sick with the Coronavirus.
Parental Signature:__________
Date:____________
Photo permission:
I give permission for photos of my son/daughter to be used on the JCD instagram stories or other JCD promotional material. YES | NO
_____________________________________(cut here)
Jerusalem Cake Design Health Declaration
Student Name:______________
Student Teudat Zehut:_________
We certify that:
we measured the temperature, and the body temperature is under 38 degrees celsius.
The student doesn’t have a cough and does not have breathing difficulties or loss of taste or smell.
To the best of our knowledge, the student has had no known exposure to someone sick with the Coronavirus.
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Date:____________
Photo permission:
I give permission for photos of my son/daughter to be used on the JCD instagram stories or other JCD promotional material. YES | NO
_____________________________________(cut here)
Jerusalem Cake Design Health Declaration
Student Name:______________
Student Teudat Zehut:_________
We certify that:
we measured the temperature, and the body temperature is under 38 degrees celsius.
The student doesn’t have a cough and does not have breathing difficulties or loss of taste or smell.
To the best of our knowledge, the student has had no known exposure to someone sick with the Coronavirus.
Parental Signature:__________
Date:____________
Photo permission:
I give permission for photos of my son/daughter to be used on the JCD instagram stories or other JCD promotional material. YES | NO
_____________________________________(cut here)
Jerusalem Cake Design Health Declaration
Student Name:______________
Student Teudat Zehut:_________
We certify that:
we measured the temperature, and the body temperature is under 38 degrees celsius.
The student doesn’t have a cough and does not have breathing difficulties or loss of taste or smell.
To the best of our knowledge, the student has had no known exposure to someone sick with the Coronavirus.
Parental Signature:__________
Date:____________
Photo permission:
I give permission for photos of my son/daughter to be used on the JCD instagram stories or other JCD promotional material. YES | NO
_____________________________________(cut here)
