KIDS Church COVID-19 Registration form 10am service: Ages 0 - 9
PLEASE READ CAREFULLY BEFORE COMPLETING.

This form needs to be completed in order for your child (Ages 0 - 9) to gain access to the Kids Church Premises.
This form serves as an official declaration. All answers must be answered truthfully.

If you have more than 1 child in Kids Church, choose the option to 'SUBMIT ANOTHER RESPONSE' at the end when this one is complete and NOT 'EDIT YOUR RESPONSE' as this will delete the data for the first child.
An individual response is needed for each child.

For more info or assistance, please contact liana@gracepoint.co.za
Sign in to Google to save your progress. Learn more
Email *
Surname *
Full Name
Date of birth of child *
Parents Contact Number *
Has your child been in contact with someone confirmed to have contracted Covid-19 within the last 7 Days? *
Has your child had any of the following symptoms in the last 7 days or currently? *
Required
Does your child have a mask which they 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!!!!!
Body Temperature Reading (Reading taken on Sunday)
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy