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Burger and beer at The Garden Room at the Killarney Park Hotel

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Fresh Fish and Chips Killarney Park

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Summer Salad The Killarney Park

Self Declaration Form

Covid-19 Hotel Stays

Please fill out one form per person prior to arrival to the hotel.

In light of the global risks associated with COVID-19, no Company can guarantee a risk-free environment and protection against the spread of COVID-19 is a joint responsibility between our guests and Hotel team. Preventative measures are in place throughout the hotel and these protocols and precautions must be complied with by all.

Therefore, in the interests of safety of guests, Hotel team, visitors, families and the wider community, we ask that you complete the following self-declaration form prior to your arrival at the Hotel. Your co-operation and support are appreciated in helping protect everyone in our hotel.

All information obtained through this form will be stored in line with the Data Protection Policy.
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region Country
Email*
Have you any of the following symptoms now or in the past 14 days?
- Cough
- Fever
- High Temperature
- Sore Throat
- Runny nose
- Breathlessness
- Flu like symptoms
- Lack of sense of smell
- Lack of Sense of taste
Have you been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days?*
- Yes
- No
Do you live in the same household/or have you been in close contact with someone who has symptoms of COVID-19 and/or who has been in isolation within the last 14 days?*
- Yes
- No
Are you a visitor to the island of Ireland and or returning from another country (including Northern Ireland) within the last 14 days?*
- Yes
- No
If ‘YES’, please state the country?
If you have left the Republic of Ireland for any period of time, you are required to self-isolate for a period of 14 days prior to returning back into the country, do you understand this requirement?*
- Yes
- No
I confirm that I have responded to the questions above truthfully based on my current condition and I commit to advising the Hotel if this situation changes.*
- Confirm
Date*

Day
Month
Year
We recommend you download the Irish Government Covid19 Tracker App.

Town Centre,
Killarney, Co. Kerry V93 CF30
Ireland
+353 64 66 35555
info@killarneyparkhotel.ie

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