Mass Registration at Divine Mercy, Oct 31st at 4PM
Email address *
Name #1 Last Name, First Name *
Name #2
Name #3
Name #4
Name #5
Do you or anyone in your household have any Coronavirus symptoms? ex. fever, cough difficulty breathing, loss of taste or smell, etc. *
Have you or anyone in your household had contact with anyone who has been diagnosed with or may have symptoms associated with COVID-19? *
I understand and agree that I will wear my mask throughout mass *
I understand and agree that I will be assigned a spot and I will remain in this spot for the duration of mass except to receive communion. *
I will practice social distancing and be attentive to the signage and the direction of the attendants, ushers and parish staff. *
Are there any special considerations we need to know about? ie: need to sit in the back, need to sit in front, uses a wheelchair, etc
Do you plan to receive communion on the tongue? *
If needed would you be agreeable to be seated in the choir loft? *
When the Church is full, I don't mind sitting in the Parish Hall from time to time.
Clear selection
Never submit passwords through Google Forms.
This form was created inside of Roman Catholic Diocese of Syracuse. Report Abuse