GOUVERNEMENT DE LA POLYNESIE FRANCAISE SANITARY ENTRY FORM ON THE CONDITIONS OF ENTRY BY AIR TO FRENCH POLYNESIA NON RESIDENT (1 FORM PER ADULT) Surname of head of family First Name(s) Gender Female Male Date of birth (mm/dd/yyyy) Passport number...
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GOUVERNEMENT DE LA POLYNESIE FRANCAISE SANITARY ENTRY FORM ON THE CONDITIONS OF ENTRY BY AIR TO FRENCH POLYNESIA NON RESIDENT (1 FORM PER ADULT) Surname of head of family First Name(s) Gender Female Male Date of birth (mm/dd/yyyy) Passport number Nationality Country of residence Mobile phone number (+ ) Email address Emergency contact in your country of residence (Surname/First name/Phone number) Number of children travelling with you Children identity #1 Surname First Name Date of birth Children identity #2 Surname First Name Date of birth Children identity #3 Surname First Name Date of birth I declare, Mr / Mrs…………………………………, that I have tested negative to the SARS-CoV-2 genome detection test (e.g. the SARS-CoV- 2 RT-PCR test) performed within 72 hours before the flight. that all minor members of my family travelling with me have tested negative on the SARS- Co V-2 (e.g. the SARS-CoV-2 RT-PCR test) performed within 72 hours prior to the flight. that I have no symptoms suggestive of CO
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