April 2021 8:30am Traditional Services - Registration
Please fill out this form and click submit.
Please be sure to arrive no earlier than 15 minutes before service.
Masks must be worn at all times.
Name
*
Email
This address will receive a confirmation email
Phone
*
Number of Attenders
*
Number of children 5 & under who may attend nursery?
*
Dates attending
*
Please select all that apply.
4/11/21
4/18/21
4/25/21
Screening Questions
1. Have you (or anyone in your household) experienced any symptoms of COVID-19 such as cough, shortness of breath or fever within the past 14 days?
*
Please select all that apply.
Yes
No
2. Have you (or anyone in your household) been in physical contact with anyone who has tested positive for COVID-19 or has otherwise unexplained symptoms of COVID 19 such as cough, shortness of breath, fever, within the past 14 days?
*
Please select all that apply.
Yes
No
3. Have you (or anyone in your household) tested positive for COVID-19 or experienced otherwise unexplained shortness of breath, cough, fever, or other flu-like symptoms in the past 14 days?
*
Please select all that apply.
Yes
No
If yes to any of the above, please explain.
Submit
Description
Please fill out this form and click submit.
Please be sure to arrive no earlier than 15 minutes before service.
Masks must be worn at all times.
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