Due to the ongoing and rapidly changing situation with the novel-coronavirus (COVID-19), we are requiring all visitors to Rox Boxing Gym to fill-out the self-declaration form below. Rox Boxing will make a decision on access to the gym based on the answers provided below.

Each visitor must complete this form.

Do you have any of the following flu-like symptoms:

Please list the country/cities you have travelled to in the last 14 days prior to arriving at Rox Boxing Gym

Name of Country/City

Date of arrival

Date of departure

Have you or an immediate family member come in close contact with a confirmed case of the coronavirus in the last 14 days? (“Close contact” means being at a distance of less than one metre for more than 15 minutes.)

This document will be retained confidentially by the Gym for one month after submission. The health and well being of our community is our first priority therefore Rox Boxing Gym reserves the right to deny entry to the gym.

Private Data Protection notice:
We are collecting and processing this personal data on the basis of Art. 6 (1)(f) and Art.9 (2)(i) Regulation (EU) 2016/679 (“GDPR”) being necessary for the purposes of the legitimate interests pursued by Rox Boxing Gym and necessary for protecting against serious cross-border threats to health. We do this as preventive measures for our community to mitigate the risk of a novel Coronavirus disease (COVID-19) outbreak in our gym. Also, we are collecting personal data to be able to support local authorities in case of an outbreak in Bangalore. In such a case, this data will help the authorities to trace a human-to-human transmission of the Virus. This data sheet will be stored in our office and is not shared with any third party unless there will be an official request by the local authorities for reasons of public interest in the area of public health. The datasheet will be deleted one month after collection unless a longer period is required by the public authorities.
Thank you for your cooperation!

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