Saint Dimitrie the New Church - Sign-in sheet during COVID-19 Pandemic
Frederick, CO, United States
NAMES *
Enter ALL NAMES (First & Last) of the persons that are in the group
Phone *
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Email *
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Group Size *
How many persons in the group. Make sure that ALL the NAMES (First and Last) are entered above
I CERTIFY THE FOLLOWING AS TRUE:
✹ I have not been diagnosed with COVID-19 and I currently do not have symptoms of COVID-19.
✹ I am not a healthcare professional who cares for COVID-19 patients.
✹ I have not been exposed to others who have COVID-19 and I am not caring for anyone with COVID-19.
✹ I am not especially vulnerable to COVID-19 due to age or an underlying medical condition as defined by Health Canada and/or Provincial health authorities.
✹ I have not attended any crowed events/parties/other parishes where social distancing and safety precautions are not in place within the last 14 days.
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Required
UPON ENTERING THE PREMISES, I AGREE TO:
✹ Wash my hands and maintain two meters social distancing at all times.
✹ Wear a mask at all times (children under 8 years old are not required to wear masks). It is strongly recommended that young children remain at home during the re-opening phases.
✹ Put on a new mask after receiving Holy Communion.
✹ Not to kiss the icons, the chalice, or the priest’s hand.
✹ Follow the directions of the greeters and ushers and remain at my designated spot during the service.
✹ Depart promptly after the service, maintaining social distancing protocols.
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Required
CAUTION:
According to the health authorities, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19, including:

✹ People with chronic lung disease or moderate to severe asthma
✹ People who have serious heart conditions
✹ People who are immunocompromised
✹ People with severe obesity (body mass index [BMI] of 40 or higher)
✹ People with diabetes
✹ People with chronic kidney disease undergoing dialysis
✹ People with liver disease

While our parish is taking precautions to prevent the spread of COVID-19, we cannot guarantee that you will not become infected. Attending services may increase your risk of contracting COVID-19, especially if you are over 65 year old or have an underlying health condition. By entering, you voluntarily assume this increased risk of exposure or potential infection with COVID-19.
Signature *
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