The Form You’ll Be Asked to Fill Out Before You Attend Services

The date for our reopening isn’t set yet, but we make this form available now so that you can begin discerning whether you’ll attend an in-person service, or simply continue worshipping with us online.

Help Us to Protect Each Other & Constrain the Spread of Covid-19

We’re so glad you’re worshipping with us this morning. We are committed as a community to protecting each other and our neighbors from the Covid-19 pandemic by putting in place the following procedures. Please read through them carefully and sign this card to indicate your willingness to adhere to them before you are admitted to the service. For contact-tracing purposes, we ask that you provide contact information. We will not add you to any newsletter list or use this information for any purpose other than contact tracing. By signing at the bottom of this card, you agree to contact us if you become ill or have contact with any known carrier of the Covid-19 virus. We will not use your name when letting people know that they’ve come into contact with someone carrying the virus. We ask that all present observe our guidelines and rules for health and safety during worship. We cannot and do not guarantee the absence of risk from your presence with us.

I attest that

  • I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
  • I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19. 
  • I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.
  • I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

I agree to

  • Allow my temperature to be taken before entering the worship space.
  • Wear a mask while I am in the worship space.
  • Maintain social distancing of six feet while in the worship space.
  • When worshipping in the sanctuary, follow the traffic flow pattern laid out on the floor.
  • Wipe down my pew or chair with the supplied hand wipes before leaving the worship space.
  • Follow any procedures posted on signs or electronic kiosks while in the worship space.
  • Follow verbal instructions from the worship leader during the course of the service.

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