BIC Jumu'ah Salah Registration Form
The information collected in this form is mandatory by the Province of Ontario. This information will only be shared in the case of a Covid-19 related emergency. One form must be completed per individual.
Email address *
Before proceeding please complete this assessment: *
First Name *
Last Name *
Phone Number *
Current Residential Address *
Which Salaah will you be attending? *
Are you between the ages of 14-70 years? *
If you do not fall between this age bracket, we ask that you pray at home. God will reward you for your intentions.
Do you have any chronic (long-lasting) health conditions? (ex. Asthma, Heart condition, Diabetes, Emphysema) *
* If yes, you are asked to pray at home. God will reward you for your intentions.
I agree that I will make wudhu at home and wear the mandatory mask. *Gloves are highly recommended. *
Please be advised that there is no access to water/washroom facilities.
I, being aware of my own health and physical condition, and having knowledge that my participation in the Friday Prayer may expose me to Covid-19 or any other health conditions. Having such knowledge, I hereby assume all risks connected therewith and consent to participate in the Friday Prayer. *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy