declaration form PLEASE FILL OUT THE FORM 2-3 DAYs BEFORE YOUR LESSON

*Even though legal measures have changed, the risk of infection and therefore our risk assessment remain unchanged and procedures will stay the same.
You get the option on the form below to declare if you absolutely cannot wear a mask, in which case your teacher can make an informed decision whether to go ahead with the lesson.* 
READ OUR FULL POLICIES HERE

Step 4 Covid19 Declaration Form Lesson at Student's House
  • What lesson date does this form relate to? :
  • I have consulted anyone vulnerable/at risk I am in contact/live with about having face to face lessons:
  • I have read, understood and will follow all the procedures to get my house and dedicated teaching space ready:
  • I haven't had symptoms outlined in the policies in the last 10 days, tested positive,been contacted by Test&Trace or been a contact of a positive case:
  • I will contact Eximo immediately if I, someone I live with or a close contact, develop symptoms/tests positive after sending this form:
  • I am prepared for my lesson and have all my lesson materials ready:
  • I have read and agree to the general T&C's:
  • Whilst risk has been assessed and mitigated as much as possible, there is still a risk of infection. I confirm I am happy to take this risk:
  • Check you have filled out all the asterisked boxes, otherwise you will receive an error message:
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