Declaration Form

Dear Guest,

Due to the recent outbreak of the Corona viruses and in line with the Government of Indonesia’s directives to mitigate the spread of Corona viruses, and having regard for your health and safety and that of the other guests, we would request for your cooperation in taking precautionary measures to prevent the spread of the new coronavirus-related pneumonia. If you could kindly fill out this declaration it would be most appreciated. In providing the below information, you consent to our collection, use, processing, transfer, and/or disclosure of your personal data in accordance with all applicable laws for the purposes of monitoring, evaluating, and responding to the novel coronavirus (2019-nCoV) outbreak.
If you answer is “Yes” to any of the question 2-4, may we suggest that you monitor your health for at least 14 days. If you become ill with symptoms listed in item 1, do inform us immediately. Or if you have checked-out of the hotel, we suggest you see a doctor immediately.