Request edit access
Emmanuel & Grace Presby
19 June 2022 Service at 8h30

WE ARE IN LOCK-DOWN LEVEL 1.
Please do not attend if in the last 5 days you have you have been exposed to someone who has tested C19+.
SAFETY FOR OTHERS IS OUR PRIMARY CONCERN.

For the sake of one-another and our community we need to do this as responsibly as possible and so please note the following:
* You must wear your mask throughout the service
* Your temperature will be checked
* Households will be able to sit together
* You are required to maintain responsible physical distance (no hugging or hand-shaking)
* Only one service will be held on Sunday.
* There will not be Tea and Coffee afterwards

Sign in to Google to save your progress. Learn more
Exclusion Criteria
Please note that if ANY of the following are true of you, then you CANNOT attend...
* Have you recently travelled to or from a Covid High risk area?
* Have you been in contact with someone who has tested Covid positive in the last 14 days?
* Do you have fever, chills, body-ache or other flu-like symptoms?
* Do you have a dry cough?
* Have you experienced a loss of taste or smell?
* Do you have difficulty in breathing (outside of existing medical conditions)?


Additional Commitments
* If while attending, I do not feel well, I will inform the Minister or one of the Elders immediately.
* If I test positive for Covid19 or suspect I have Covid19 within 10 days of attending the service, I will contact the minister.

One Form per Family living at the Same Address
Surname *
Your name and (if applicable) the members of your family who are with you (Show different surname in brackets) *
Number of people attending *
Declaration: I hereby declare that none of the "Exclusion Criteria" above apply to the people listed here and that I/we agree to the "Additional Commitments". *
Required
Residential Address: *
Cell# *
Email *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy