A: Head of the Group

PERSONAL DETAILS

CONTACT DETAILS

B: Travel Details

ORIGIN:




DESTINATION:




C: Other members on the group (Excluding the head / leader):

MEMBER 1

Attach Profile Picture of Member 1

D: Agreement

I hereby certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me from this program. Furthermore, I hereby declare my willingness to undergo a minimum 14-day quarantine, a COVID-19 rapid/PCR test and/or such other policies imposed by the local goverment unit of my destination.