ISDA Conferences Health Declaration Email (required) To assist us in protecting the health and safety of all participants and ISDA employees, please answer the following questions: IN THE PAST 14 DAYS, HAVE YOU OR DO YOU ANTICIPATE TO HAVE BY THE DATE OF THE CONFERENCE: 1. Traveled from, or through Mainland China, Hong Kong, Italy, Iran, Macau, South Korea or a location currently subject to lockdown (quarantine) measures by the United States Center for Disease Control (“CDC”), Public Health England, World Health Organization (WHO) or other applicable agency (including transiting through an airport in these locations)? YesNo 2. Had contact with a suspected or confirmed case of coronavirus (COVID-19), or a person under monitoring for coronavirus? YesNo 3. Traveled from, or through any of the locations listed below (including transiting through an airport in these locations)? YesNo If Yes then please check all which apply JapanSingaporeTaiwanThailandVietnam 4. In the past 14 days or currently, do you, or have you had, a fever, cough or difficulty breathing? YesNo This questionnaire is intended to promote healthy awareness of the recent spreading of the Coronavirus (COVID-19). If you are sick, or are displaying any of the symptoms identified by public heath authorities, please stay at home. Please find more information on what ISDA is doing to protect its conference participants on its website here. Data Privacy ISDA is requesting the provision of, and will subsequently process, the personal data provided in response to the questions above. The purpose of that processing will be to identify any individuals who represent a high risk of infection with Coronavirus (COVID-19) and prohibit their attendance at any ISDA events in order to protect public health and restrict further spreading of Coronavirus (COVID-19). ISDA will provide a full refund to any such prohibited individuals and would be happy to discuss with them future alternative event options. For further details on data privacy please refer to ISDA’s privacy policy. By checking the following box and submitting this form: 1. I understand that ISDA will process only the personal data provided to it in this declaration, 2. that personal data constitutes a special category of personal data pursuant to Article 8 of the General Data Protection Regulation, and 3. I explicitly consent to the processing of such special personal data. By checking this box and submitting this form, I certify that the above declaration is true and correct. To submit this form electronically please sign below and click the "Submit Form" button. Full Name Δ
