In-Person Attendance | Miracle Temple COGP

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Socially Distant In-Person Service

Registration Form (Must be complete separately for each person).

*SPACE IS LIMITED AND THIS FORM MUST BE COMPLETE BEFORE ATTENDING.

First Name

Last Name

Email

Phone

My body temperature is lower than 98.6°F/ 37.5°C

I am not experiencing the symptoms: fever, cough, sore throat

I haven’t been in close contact with a Covid-19 patient in the last 14 days

Initials

Date

I declare that the info I’ve provided is accurate & complete

This form no longer accepts submissions. We have reached our in-person capacity.

733 S. Grevillea Avenue, Inglewood, CA 90301 | 310.419.7335 or 310.672.2338 | info@cogpinglewood.org

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