Registration

Service
Name
Mobile
Email
Address
Total Members (Including yourself)
Are you and all your Family Members who plan to visit the Jubilee Revival AG Church Above 10 years and Below 65 years of age?
Are you and all your Family Members in General Good Health? Which means NO Fever, Sneezing, Coughing, and previously existing Health Condition of concern.
I or my Family Members have not travelled / returned from overseas in the last 14 days
I or my Family Members have not contacted people who are suspected / confirmed Covid-19 cases
My residence is not in a containment zone / area