In-Person Children's Program Pre-Registration  
We look forward to seeing you at our in-person Children's Program this Sunday!
To ensure the health and safety of all participants, please submit this registration and screening form by Saturday.
Sign in to Google to save your progress. Learn more
Children's Ministry Protocols for COVID Case Report:
In addition to the government protocols*,

GROUP 1
CHILDREN WHO ARE TESTED POSITIVE DURING THE WEEK AND ATTENDED A PRIOR SUNDAY PROGRAM, they may return to church:
1. AFTER 10 days from symptom onset or from the date of their test (whichever came first) WITH the latest negative RAT result (confirm verbally), OR
2. AFTER 14 days from symptom onset or from the date of their test (whichever came first) WITHOUT the need of a negative RAT result.

GROUP 2
CHILDREN WHO ATTENDED A SUNDAY PROGRAM WITH SOMEONE WHO TESTED POSITIVE FROM LATER IN THE WEEK, they may return to church:
1. the following Sunday WITH a NEGATIVE RAT RESULT (confirm verbally)
2. AFTER the 10-day self-monitoring period with NO SYMPTOMS.

REPORTING A CASE
To report a POSITIVE COVID case from the week when your child attended a prior Sunday program, please contact ONE of the following:
1. Rev. Ada Chung at adachung@stouffvillegrace.ca
2. Rev. Hubert Wu at hubertwu@stouffvillegrace.ca.

REGULAR REQUIREMENT
FOR ANYONE WHO IS ATTENDING THE CHILDREN’S PROGRAM THE UPCOMING SUNDAY, MUST:
1. SELF-SCREEN on SUNDAY MORNING
2. WEAR A MEDICAL MASK, cloth mask is an optional second layer.
---

*https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/school_childcare_guidance_omicron.pdf
Child's Name *
Child's Age *
Any Allergies (please specify)
Parent's Name *
Contact Email *
Emergency Phone Number *
Is your child experiencing any of the following symptoms?  -  Fever, cough, sore throat, runny nose, nausea, vomiting, diarrhea, loss of taste or smell, difficulty breathing, headaches, extreme tiredness, sore muscles.   ** If you answer "YES", we would advise that your child refrains from coming to church! **   *
Required
Has your child been tested positive for COVID-19 in the past 10 days? *
Has your child had close contact with a confirmed or probable case of COVID-19 in the past 10 days? *
Collection of Personal Information - Under government’s guidance on reopening under COVID-19, places of worship have to ensure a way to contact attendees in the event that an attendee tests positive or an outbreak is identified. I understand that as a support for public health contact tracing efforts, all attendees of Stouffville Grace Baptist Church (SGBC)’s in-person worship services are required to pre-register and to provide personal information (name and contact information). By proceeding to register, I give consent to SGBC to collect and use my personal information for the aforesaid contact tracing purpose. *
Required
Declaration of Compliance and Assumption of Risk Related to COVID-19. - Following Provincial government’s approval and public health’s guidance on reopening under this challenging COVID-19 pandemic, Stouffville Grace Baptist Church (SGBC) reopens its church building for in-person worship services with public health and workplace safety restrictions in place. While SGBC takes extra-precautionary measures including enforcing mask-wearing, 2-metre physical distancing within church premises, frequent cleaning and sanitizing common areas to protect service attendees as well as community members’ health and safety, there is no guarantee that the premises is free from exposure to COVID-19. By submitting registration for attending SGBC in-person worship service, I agree to abide by the procedures established and enforced by SGBC to protect the health and safety of all attendees, volunteers, guests and staff and I voluntarily assume the risk that I and/or my family may be exposed to or infected by COVID-19 by attending SGBC services, gatherings or programs. I understand that such exposure to the COVID-19 virus may result in personal injury, illness, permanent disability or death. I agree to release SGBC and EastRidge Church from all liability and waive my right to sue either as I assume all risks of participating in this activity. I understand and accept the above declaration: *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Stouffville Grace Baptist Church. Report Abuse
Google Forms