To prevent the spread of COVID-19 in our community and reduce the risk of exposure to our staff and visitors, kindly complete this health declaration form honestly. Your participation is important to help us take precautionary measures to protect you and everyone in our hotel. Failure to answer or giving false information is punishable in accordance with Philippine laws.

Please fill-up the form below. Thank you for your time.
Full Name: *
Contact Number: *
Clear selection
Address in the Philippines *
Body Temperature:
Please check if you have any of the following at present or during the past fourteen (14) days. Select None of the Above if you don't have any symptoms: *
Data Privacy Notice: The Rose Pike Boracay/FSB Resorts Boracay, in line with Republic Act 10173 or the Data Privacy Act of 2012, is committed to protect and secure personal information obtained in the performance of its duties. The establishment collects the following personal information relevant in the advancement of protocols and precautionary measures against COVID-19 Acute Respiratory Disease. The collected personal information will be kept/stored and accessed only by authorized personnel and will not be shared with any outside parties unless the disclosure is required by, or in compliance with applicable laws and regulations.
Declaration and Data Privacy Consent Form:
I knowingly and voluntarily agree to the terms of this binding Declaration, and in doing so represent the truthfulness and veracity of the above answers. I understand that failure to answer any question or giving false answer can be penalized in accordance with the law. Relative thereto, I voluntarily and freely consent to the processing and collection of personal data only in relation to COVID-19 internal protocols.
Select Yes to confirm and agree for the consent form *
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