Gracepoint Church COVID-19 Registration form 10am service.
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Email address *
Date you will be attending the service (only current week registration) *
MM
/
DD
/
YYYY
Surname *
Name *
ID Number (Date of birth if child)/ Passport number *
Contact Number *
Have you been in contact with someone confirmed to have contracted Covid-19 within the last 7 Days? *
Have you had any of the following symptoms in the last 7 days or currently? *
Required
Do you have a mask which you will wear in this facility at all times? *
I hereby declare to the best of my knowledge that the information disclosed is correct at the time of completion. *
!!!!The section below is for Gracepoint office use only. PLEASE IGNORE!!!!!
PLEASE DO NOT COMPLETE: Body Temperature Reading (Reading taken on Sunday the 29th) To be completed Sunday on your arrival, by a Gracepoint official
A copy of your responses will be emailed to the address you provided.
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