Monsieur Madame Entry Ticket
Please fill in the form for your estimated Entry and Exit time. This will be used for Covid-19 Contact Tracing. Thanks for your understand. All Information is kept strictly confidential between NZ GOVT and MONSIEUR MADAME. All Data Will Be Securely Destroyed After 2 Months
By Submitting this form, you agree to the following COVID-19 measures set out by NZ GOVT. You agree to providing information to the BEST of your knowledge. MONSIEUR MADAME
Please tick yes if you agree to the above statements. Only then you may enter the restaurant. All Data Collected Will Be Securely Destroyed Within 2 Months *
Required
Are you here for DINE IN or TAKEAWAY *
Required
Full Names of ALL the people entering *
Email *
Phone Number *
Which Suburb Do You Live In *
Time you Entered *
Estimated Time You Will Leave *
Submit
Never submit passwords through Google Forms.
This form was created inside of The University of Auckland. Report Abuse