Travel Well Declaration: Bali Retreat: August 20-27:2022

Travel Well Declaration:

Please complete and submit this form to the Tour Operator, Amy of The Cotour, within 48 hours of travel. You may scan or photograph and email, but a hard copy is required to be mailed or couriered to the service address of The Cotour. This is part of your tour registration and -participation in the tour is contingent on this form being filled out and certain criteria met.


By joining a tour with The Cotour – it’s important that every guest assumes personal responsibility for their own health to help protect – the well being of their fellow travellers, the Tour Operator, the Cotour staff, contractors, our supply partners, and the places we visit. To assist us in this important goal we are implementing the Travel Well Declaration for this tour:


Trip Start Date:   August 20: 2022

Trip Finish Date: August 27: 2022

Name of Trip: The Cotour - Bali Retreat with Rachel Hunter and Renee Stewart – special guests



_________ I confirm that I am up to date with my vaccinations for Covid-19 meaning:      

  1. Having had a Covid-19 vaccine that has been approved by the New Zealand Health authority
  2. Having followed the New Zealand government health authority recommendations relating to dosage and any booster requirements
  3. Having completed the time period between your last vaccination and when the New Zealand government health authority considers you to be fully vaccinated
  4. If from New Zealand your International Travel Vaccination Certificate must be provided as proof


_________ I confirm that I do not currently have and have not recently had a new or

  • a fever
  • temporary loss of smell or altered sense of taste
  • sore throat
  • shortness of breath.
  • a new or worsening cough
  • sneezing and runny nose
  • or any other symptoms associated with Covid-19


________ I confirm that I have taken a supervised Covid-19 test – within the specified time frame – as requested by the Tour Operator and will provide this documentation to the Tour Operator.


_______ I understand that The Cotour, and any contractors, suppliers or anyone else involved in the tour – can not guarantee that I, or those I’m travelling with, will not become infected with Covid-19. As such I agree to hold The Cotour harmless and voluntarily assume all risks and expenses in the event that I, or any member of my traveling party becomes infected with Covid-19.


_______ I pledge that the above declarations are true and understand that any dishonest answers may have serious public health implications. I agree to take personal responsibility for my health and well-being, to follow Covid-19 protocols, such as wearing a mask and social distancing – as required by The Tour Operator, local health guidance or our supplier partners. I understand that non-compliance with these measures by myself or travelling party may, or will, result in our party not being able to continue on this tour.


Name: _______________________________

Signature: _____________________________

Date: __________________________________