When: Tuesday 28th September 2021 @ 8pm
Where: Leixlip Youth & Community Centre, Newtown House, Captains Hill W23T8W5

Public meeting, please wear a face mask, and follow social distancing guidelines
Email *
Full Name *
Please indicate your interest in attending the Leixlip Youth Premises Group AGM *
Area of Interest in attending the AGM
About you
Have you had symptoms of COVID-19 / been identified as a CLOSE CONTACT / been asked to self-isolate / or are awaiting results of a Covid-19 test / returned from travel to a designate state in the past 14 days ? *
If you have answered YES, you must stay at home and contact your family GP by phone for further advice.

Please seek medical advice immediately if you have any Covid symptoms including symptoms associated with the Delta variant - headache, sore throat and blocked or runny nose (however mild). Do NOT attend the event

If you have answered NO, you may attend the event
I consent to being sent an email reminder about this event *
Data Protection Notice. Your personal data is being collected on this form in order to process your order for Leixlip Youth Premises Group CLG. Your personal data is being processed in accordance with Article 9(2)(i) of the General Data Protection Regulation, and Section 53 of the Data Protection Act 2018. The information you provide on this form will not be used for any other purpose and will be strictly confidential. Your information will be stored securely on the Leixlip Youth and Community Centre Management System.
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