KCPC DC On-Site Worship Service Registration for Walk-Ins

Please complete this registration form prior to entering our on-site worship service. Once you show your registration form submission to the Welcoming Team, please check your temperature and sanitize your hands at the Welcoming Desk.

Thank you for your cooperation and understanding as we are undertaking many precautions to gather safely. Please check out our website for further information: https://dc.kcpc.org/covid-19-updates.

Hyatt Centric Arlington // 1325 Wilson Blvd, Arlington, VA 22209
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Email *
Name *
Phone Number *
Worship Service Date *
Are you 65+ years old? *
Are any family members (including children and youth) attending with you? If yes, please provide their name and age:
Have you had any of the following symptoms in the last 24 hours: fever of 99.5 degrees or higher, cough (not related to allergies), sore throat, runny nose, shortness of breath, chills, muscle aches, loss of smell and/or taste? *
Have you been in close contact with an individual confirmed with COVID-19 or with at least one of COVID-19 symptoms? *
Have you traveled inside and/or outside of the U.S. within the past 14 days? *
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