Covid-19-contact registration

Covid-19 contact registration

Chocolatemuseum Cologne
In order to contain the CoVid-19 pandemic, we collect the contact details of our guests in accordance with the Corona Protection Ordinance NRW. Access to the Chocolate Museum is only possible after all visitor data has been recorded.
Date and time of your visit *

Tag Monat Jahr
Date hour minute
Number of person: *
You can check in max. 6 people
Name of applicant *

First name Last name
Adress *

Street

Further information

Post code City

Federal state
E-Mail *
beispiel@beispiel.de
mobile number *
Name of accompanying person 1 *

First name Last name
Same contact dates

No
Adress *

Street

further information

post code City

federal state
E-Mail *
beispiel@beispiel.de
mobile number *
Name of accompanying person 2 *

First name Last name
Same contact dates

No
Adress *

Street

further information

post code city

federal state
E-Mail *
beispiel@beispiel.de
mobile number *
Name of accompanying person 3 *

first name last name
same contact dates

No
Adress *

Street

further information

post code city

federal state
E-Mail *
beispiel@beispiel.de
mobile number *
Name of accompanying person 4 *

first name last name
same contact dates

No
Adress *

Street

further information

post code City

federal state
E-Mail *
beispiel@beispiel.de
mobile number *
Name of accompanying person 5 *

first name last name
same contact dates

No
Adress *

Street

further information

post code City

federal state
E-Mail *
beispiel@beispiel.de
mobile number *
Impressum Datenschutz

Jotform by Klaus H. Schopen
Should be Empty:

Covid-19 contact registration