COVID -19 Screening Witbank Baptist Church
Compulsory screening before church attendance
All sections with red stars are compulsory - you won't be able to use the "NEXT" button at the bottom of the page if all those questions have not been answered
Date *
MM
/
DD
/
YYYY
Personal Information
Temperature (to be taken at church)
Name *
Surname *
Residential Address *
Contact Number *
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