ATTENDANCE REGISTER QUESTIONNAIRE

Name *

First

Last

MSA monitors the situation regarding the Coronavirus daily and follows directives from the Government Health Authorities. The health and wellbeing of our community is our first priority. At this time, we will require you to answer the following questions. MSA reserves the right to deny anyone entry to the event.

ID Number *

Email *

Phone

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

MSA Event *

Date / Time

Date

Time

MSA Permit Number *

Location Of MSA Event *

Do you live with other people? *

Yes
No

If yes, please provide full contact details of all individuals residing with you:

1. Name

First

Last

Details