REGISTRATION FORM

Welcome to Blue Moon Hotel! We are delighted to have you stay with us, and
we hope you have a relaxing and happy stay. Everyone traveling must fill out
the travel registration form before setting out. Children should always be with
adults. Additionally, as a precaution against COVID-19, each guest must join
the hotel with a negative swab test result within 72 hours.

PERSONAL INFORMATION
FULL NAME:

HOME ADDRESS:

DATE OF BIRTH:

CONTACT NUMBER:

EMAIL:

TYPE OF VALID ID:

ID NUMBER:

LIVING ARRANEGEMENT / ACCOMMODATION

RESIDENTS OF BORACAY? *Present proof of residence such as a driver’s licence, mortgage, rent,
lease agreement, property tax document, or your health card.
Home Address:________________________________________________________________
WORKER? *Present proof of employment. If urgent unplanned work on critical infrastructure, a letter from
your employer describing work, timeframe, travel and isolation plan.

VISITOR? *If you are visiting please present an invitation letter with: Complete Name of the Person Visiting,
Home Address, Contact Number, State the Reason of Visitation, How long will the visitor stay and other
necessary information.

TOURIST? *Present a booking confirmation from the hotel.

Name of the Hotel:__________________________________________________________________________

MODE OF TRANSPORTATION UPPON ARRIVAL

TIME OF ENTRY:
AIR: Flight Number
LAND: Licence Plate Number
SEA: Time and Date Arrival

LAST LOCATION BEFORE ARRIVAL IN BORACAY:

 FIRST LOCATION BEFORE ARRIVAL IN BORACAY:

NTACT LIST OF THE LOCATIONS VISITED IN THE LAST 14 DAYS:

ORMATION
CONSENT: COVID-19 TEST
 Health Screening
 Risk Assessment at Port of Entry
Including: Temperature Check
Observing Respiratory Signs
Interview by Health Officer
(Swabbing on Arrival if Symptomatic)

Check if You Agree:

I will present my negative test result for COVID-19 on swab test within 72hrs to the
health authorities.

I will get a test at my cost and will remain in quarantine until I receive a negative
result if symptomatic.

I will follow protocols by wearing a mask while in public, as required by Philippine

law and will maintain 2meters of physical distance from others.

ATTESTATION:
I have read and understood the terms. I certify that the information are true and accurate to the
best of my knowledge and I agree to comply with all rules, protocols and the laws of the
Philippines. I make this declaration knowing that if I fail to furnish any required information or
knowingly furnish false information I commit an offence and shall be liable to a fine or
imprisonment.

_________________________________
SIGNITURE ABOVE PRINTED NAME