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2021 ULI Asia Pacific Summit Health Declaration Form

Questions marked with a * are required

ULI seeks your cooperation to complete the following form to allow everyone to convene in a safe environment and facilitate contact tracing, if necessary.

Contact Information

First Name

Last Name

Phone

Email Address

Do you have/have you had any of the following symptoms now/within the last 14 days: cough, smell/taste impairment, fever, breathing difficulties (even if your symptoms are mild)?

Yes

Have you been in contact with anyone who is suspected to have or has been diagnosed with COVID-19 within the last 14 days?

Yes

I hereby declare that I have answered the above questions truthfully. I understand that a false declaration is equivalent to an attempt to wilfully deceive the organisers and cause harm to public safety.

Conditions of Entry

Please note that any person returning a temperature reading at or above 37.5℃ or has answered YES to the questions above may not be able to physically attend the Summit. In this instance, you may be offered the opportunity to transfer your in-person registration to a virtual event ticket. This is for the health and safety of all Summit attendees and we seek your kind understanding.

By providing personal data through this declaration form, you authorise ULI to collect, use, process and disclose personal data provided for the purpose of verifying your identity, screening your health status and maintaining records of visitors to the Summit for contact tracing, to ensure everyone's safety and security.