Statement responsible for the Aeolian community ESAD

1Personal data

2Responsible statement

Information from the parent or guardian
First and last name*
Name Surnames
Type of identification*
- DNI / NIE
- NO Passport
DNI / NIE*
Passport number*
Phone 1*
Phone 2
Electronic correu*
Enter email Confirm email
Student details
Name*
Name Surnames
Type of identification
- DNI / NIE
- NO Passport
DNI / NIE
Passport number

Self-responsible certificate
I declare, responsibly:
1. That my child, during the last 14 days and at this time:
- It does not present any symptoms compatible with COVID-19 (fever, cough, difficulty breathing, discomfort, diarrhea ...) or with any other infectious picture.
- She is not and has not been positive for SARS-CoV-2 and has not lived with people who are or have been positive.
- He has not been in close contact with anyone who has tested positive for COVID-19 or who has had symptoms compatible with this disease.
- He has the vaccination calendar up to date.
2. That in relation to the following diseases:
- Serious respiratory diseases that require medication or ventilatory support devices.
- Serious heart disease.
- Diseases that affect the immune system (for example, those people who need immunosuppressive treatments).
- Poorly controlled diabetes.
- Neuromuscular diseases or moderate or severe encephalopathies.
(Select one of the two options)*
- My child does not suffer from any of these diseases.
- My child suffers from one of these diseases and I have assessed with his / her doctor or pediatrician the suitability of resuming school activity.
3. That the decision to attend school is the result of a personal / family decision, having been able to consciously assess and weigh the benefits and effects of care, along with the health risks of my child that the current pandemic situation entails.
4. I undertake and know the obligation to:
- Monitor my child's condition by taking the temperature before leaving home (or place of origin) to go to the center Eòlia ESAD and that, in the event of a fever or any of the symptoms compatible with COVID-19, you will not attend.
- Inform the School of the occurrence of any case of COVID-19 in the child's family environment and maintain close contact with the school in the event of any incident.
5. That you will attend your referral CAP in case you have symptoms in order to request a PCR test, and will stay at home until you have the test results.
6. That I have read the regulations published by Eòlia ESAD and I undertake to comply with the instructions specified therein.
And, for the record, for the purposes of its incorporation into the center Eòlia ESAD, I sign this declaration of responsibility and I explicitly consent to the processing of the data contained in this declaration.
Privacy policy*
I agree with the privacy policy.
In application of the General Data Protection Regulation EU-2016/679 and in compliance with the provisions of Organic Law 3/2018, of 5 December, on the Protection of Personal Data and Guarantee of Digital Rights, Nova Eòlia SL informs you that the data included will be incorporated and processed in a computerized file for the exclusive use of the center, its purpose being to manage the educational action, on the occasion of the security protocols for the COVID-19 pandemic. Your data will not be communicated to third parties, except by legal obligation. In fulfillment of the duty of collaboration with the Department of Health to deal with the COVID-19 pandemic, it is necessary to assess the presence of staff, faculty and students with conditions of special vulnerability in relation to virus infection. It is especially important to protect the health of the community in relation to SARS-CoV-2 coronavirus infection.

It is also reported that you can exercise any right established by law (access, rectification, cancellation or complaint) by contacting Nova Eòlia SL at the address c / Casp, 82 baixos (08010 Barcelona) or in a email to eolia@eolia.cat.

Nova Eòlia, SL guarantees the absolute confidentiality of your data in accordance with the relevant provisions of current legislation, which the center strictly complies with.
Signature*
In case of error you can repeat / delete the signature using the symbol in the lower right corner.
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Statement responsible for the Aeolian community ESAD

Information from the parent or guardian

Student details

Self-responsible certificate

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Privacy policy