ALT COVID-19 FORM
All persons wishing to attend in-person services at Abundant Life Tabernacle are required to pre-register by 5 PM on the Saturday immediately preceding the service selected. As part of the registration process, we kindly ask each person to complete the following COVID-19 screening questionnaire. If you answer yes to any of the questions, we will not be able to facilitate you at this time and recommend that you contact your local health authorities. Thank you and God bless.
Email address *
Cough? *
Required
Shortness of breath? *
Sore throat or difficulty swallowing? *
Runny nose, sneezing or nasal congestion? *
Hoarse voice? *
Smell of taste disorder? *
Nausea, vomiting, diarrhea? *
Chills? *
Headache *
Do you have a fever? *
Have you, or someone you have been in close contact travelled outside of Canada in the last 14 days? *
Have you had any contact with anyone with a probable or confirmed case of COVID-19? *
Please indicate below your contact information (Name, address and telephone number).
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