THE MEETING PLACE CAFE
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Thank you for visiting The Meeting Place Café. During Covid-19 the Queensland government requires that we retain contact details of all dine- in customers for contact tracing purposes. The information supplied in this form will not be used for any other reasons. Please be truthful in supplying this information.
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Indicates required field
Name
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First
Last
# of dependents with you today
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Phone Number
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Email
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Address (only required if you don't have an email address.)
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Line 1
Line 2
City
State
Zip Code
Country
Are you currently experiencing any of the following symptoms? (i.e. first developed in the last 7 days) Symptoms: Loss of smell, loss of taste, cough, sore throat, fatigue, aches and pains, shortness of breath, runny or stuffy nose, headaches or raised temperature.
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Yes
No
Which event are you attending?
*
Mum's Group
Afterschool Art Space
Saturday Art Space
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HOME
OUR MENU
WHERE DO YOUR DONATIONS GO?
VOLUNTEER WITH US
Blog
Donate
THE ARTISAN PROJECT