Online check-in | Hotel Vallehermoso Cotahuasi

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ONLINE GUEST CHECK-IN FORM

(To be filled out and sent before your arrival)

CHECK-IN DATE

CHECK-OUT DATE

FULL NAME

BIRTH DATE

NACIONALITY

ID N°

PHONE NUMBER

EMAIL

PAYMENT TYPE

I accept that this document constitutes the lodging contract regulated by D.S. 12-94-ITINCI DEL 94-06-22.

Thank you for doing your check-in online!

COVID-19 SYMPTOM QUESTIONNAIRE FOR ADMISSION TO PUBLIC ACCOMODATION

(Affidavit)

FULL NAME

BIRTH DATE

TYPE OF ID

ID N°

PHONE NUMBER

EMAIL ADDRESS

HAVE YOU HAD ANY OF THE FOLLOWING SYMPTOMS DURING THE LAST 14 DAYS?

Feber

Difficulty to breath

Cough with or without espectoration

Contact with a confirmed case of COVID-19

Any other health issue

EMERGENCY CONTACT (NAME & PHONE NUMBER)

All the information provided in this form constitutes an affidavit. I have been informed that omitting or falsifying information may harm the health of third parties and my own, and constitutes a serious offense to public health. As such, it may be punishable by law and I'm willing to assume the consequences.

Thank you for filling out this form. We will contact you shortly!

Calle Tacna 106
Cotahuasi, Arequipa, Peru
[email protected]

Tel: (054) 581 057
Cel: 958 852 753