This is a non-professional translation of the French personal travel exemption relating to the COVID-19 decree.
You must download the French form below, print it and complete it and carry it on your person for each outing.
Justificatif deplacement derogatoire (original document) (ODT, 13.7KB)
English translation of the waiver
In accordance with Article 1 of the decree issued on 16 March 2020 relating to movements in the context of the fight against the spread of the Covid-19 virus:
I, the undersigned
Mrs/Mr:
Born on:
Address:
Certify my movement is related to the following reasons (tick the box) authorised by Article 1 of the decree issued on 16 March 2020 relating to movements in the context of the fight against the spread of the Covid-19 virus:
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trips between home and place of work, when there is essential need for it, because the professional activity cannot be performed at home (provide permanent documentary proof) or professional trips that cannot be postponed
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trips to make essential purchases (full list available on gouvernement.fr)
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trips for health reasons
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trips for essential family reasons, to assist vulnerable people or for childcare
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short trips, close to home, for individual physical activity, excluding collective sports, and for the needs of domestic animals
Done in (name of town or city) on (MMY) Signature
