Holy Virgin Mary & St. Pishoy Coptic Orthodox Church

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Holy Virgin Mary & St. Pishoy Coptic Orthodox Church - Liturgy Sign Up

Email *

Home Phone Number of Household *

Cell Phone Number Head of Household *

Head of Household Last Name *

Mailing Address *

Ex. 123 Church Dr. Los Angeles, CA 90049

How many people from your household including yourself plan on attending Liturgy? *

Names, ages, and mobile phone # of planned attendees (including yourself). Also please indicate who is over 65 years of age or having any underlying health conditions *

Ex. John Smith, age, mobile phone # (every name on a single line)

Available Days to Attend

Check all that apply.

Available

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Comments:

I have signed-up only once with my home church *

Yes

I am comfortable attending a liturgy with other congregants *

Yes

None of the members of my household have shown any cold or flu like symptoms within the last 14 days *

True

False

Please confirm reading the following instruction in Either Arabic or English.

Yes

Clear selection

Please read and confirm below *

All members of my household who wish to attend liturgy have read and agreed to these terms

Required

Send me a copy of my responses.

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