Dichiarazione per accesso alla struttura

I, the undersigned, ____________________________,

being fully aware of the criminal consequences for false declaration, as per art.76 of President Decree no.455 of 28/12/2000, declare that:

• I have not had any contacts with people who tested positive to COVID-19 disease in the last 14 days or coming from risky areas as declared by WHO and I also declare not to come from those areas;

• My body temperature is not exceeding 37,5° as a result of today’s measurement and I have not got any other flu’s symptoms;

• I acknowledge Anti COVID 19 Borgo Podernovo’s Protocols (as seen in the web side) and I commit myself to strictly observe them during my stay;

• Inside the apartment which I rent there are people who are not kept to social distance.

Information due to article no.13 of UE Regulation 2016/679: required data will be treated only for COVID 19 prevention in business environment and as a result and for the application of Anticontagions Procedure as for D.P.C.M. 26 aprile 2020 e sue successive modifiche ed integrazioni.
Eventual deny to release such declaration will stop you from staying in Borgo Podernovo.
Personal data kept in such declaration will be kept for the due time, strictly connected to accomplish law, so until the conclusion of the pandemica as declared by Italian Government.
Data controller is Borgo Podernovo, which registered office is located at Borgo Podernovo resort in Bolsena- Viterbo- postal code 01023. Against personal data treatment claimes as per article 15 and followings of UE Regulation 2016/679, can be addressed to legal representative, whose e mail address is info@borgopodernovo.com
Interested people have the right to represent the issue to Personal Data Authority.

Data ___________________

Firma

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