Risk Assessment Pandemic Preparedness Screening & Contact Tracing Form
ANY FALSE DECLARATION IS PUNISHABLE BY LAW.
I hereby certify that statements I will be giving below are true and correct to the best of my knowledge. I hereby authorize Camp John Hay Golf Club, Inc. to collect and process the data indicated for the purpose of effecting control of the COVID-19 infection. I understand that my personal information is protected by RA 10173, Data Privacy Act of 2012, and that I am required by RA 11469, Bayanihan Heal as One Act, to provide truthful information.
“SEC. 10. Penalties. - Any person or entity found to have violated Section 9 of this Act shall be penalized with a fine of not less than Twenty thousand pesos (P20,000.00) but not more than Fifty thousand pesos (P50,000.00) or imprisonment of not less than one (1) month but not more than six (6) months, or both such fine and imprisonment, at the discretion of the proper court. (RA 11332).”