health-declaration-form - Soban K-Town Grill

Health Verification

If you are human, leave this field blank.

COVID 19 Health Declaration Form
COVID 19 건강 문진표
冠状病毒健康申报表

The safety and protection of our team and our guests remains as the top priority of our company. As the outbreak of Coronavirus disease continues, we enjoin you to help us reduce the potential risk of exposure to all. Please answer this form completely. Thank you.

코로나 바이러스가 지속됨에 따라, 고객님과 직원분들의 상호 안전을 위하여, 아래 문진표를 성실히 작성해 주시기 바랍니다.

本团队和客人的安全和保护仍然是本公司的重中之重。随着冠状病毒疾病的持续爆发，我们要求您帮助我们降低接触人的潜在风险。请完整地回答这张表格。谢谢您。

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지점명
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CERTIFICATION AND DATA PRIVACY CONSENT
개인정보 제공 동의
认证和数据隐私同意书

I hereby authorize Soban K-Town Grill, to collect and process the data indicated herein 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 to Heal as One Act, to provide truthful information.

소반 K-TOWN 그릴이 COVID-19 감염 예방을 위한 개인 정보 수집 및 제공에 동의 합니다. 개인정보는 RA 10173, Privacy Act of 2012 보호법에 의거 보호되며, RA 11469 Bayanihan to Heal as One Act 법에 의거 정확한 사실만을 제공하는것에 동의합니다

本人特此授权索班K-Town Grill收集和处理本文所示的数据，以控制冠状病毒感染。我了解我的个人信息受菲律宾法 Republic Act 10173号，2012年《数据隐私法》的保护，并且根据菲律宾法Republic Act 11469号《巴彦尼汉治愈法》的要求，我必须提供真实的信息