Post COVID-19 LGM Entry Declaration Form
PLEASE READ: This is a one off registration/declaration and you will be given a number which you need to give to member of staff anytime you come to pray, before entry to the mosque, we will admit our congregation on first come first in basis bearing in mind the limited number of people we can accommodate at the mosque in line with the new procedures of social distancing.
Please complete the form below. Every question must be carefully answered. Unfortunately, no one will be allowed to enter without completion of this form.
First name *
Last name *
Contact number *
email address *
Do you use a chair for prayer? *
I am a high risk person or I have anyone at home who is high risk *
PLEASE READ: I confirm that I make sure that I don't have any of the following symptoms in the last 24 hours prior to any time I attend a prayer the mosque (Please tick all boxes in order to be granted entry to the mosque): *
Required
PLEASE READ: I confirm that I make sure that I fulfill all the requirements below any time I attend a prayer at the mosque (Please tick all boxes in order to be granted entry to the mosque): *
Required
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