SCBC Sunday Service Sign-Up and Covid-19 Waiver
COVID-19 is highly contagious and is known to spread mainly from person-to-person contact so we must continue to be careful and diligent. This SCBC Sunday Service sign-up and Covid-19 Waiver will help to ensure the health & safety of all who gather for Somerville Community Baptist Church service.

Please be aware that you are completing this sign-up and waiver for you and your party.

By attending service at Somerville Community Baptist Church, you and your party agree to abide by the procedures established by the church to protect attendees and staff, including wearing a mask & social distancing. You and your party agree that you will each voluntarily assume the risk that you and/or your families may be exposed to or infected by COVID-19 at the church and waive any liability against the church and any other parties. You and your party also acknowledge that for all future events/meetings that you attend, you will self-check the below questions & recommendations and follow church guidelines:

1. Please arrive between 10:30-10:40am. Check-in will be closed at 10:45am.
2. Enter church from the Morrison Ave back parking lot entrance to check-in with a
greeter.
3. Please sanitize your hands upon entering and keep your mask on at all times during the
service.
4. An usher will help direct you to your seat
5. After church service, exit your pews on the side, head directly to the back of the sanctuary and leave through the doors that lead to College Ave.
6. Please refrain from congregating indoors after the end of service.
Email *
Phone Number *
Please provide the 10 digit phone number that we can best reach you at.
Full Name *
Please provide your first and last name.
How many guests, not including yourself, will you be bringing? *
Guest 1
Please provide the first and last name of your guest.
Guest 2
Please provide the first and last name of your guest.
Guest 3
Please provide the first and last name of your guest.
Guest 4
Please provide the first and last name of your guest.
Guest 5
Please provide the first and last name of your guest.
For the following questions, if "yes" is applicable to anyone in your party, please select "yes" for all. If you answer yes to any of these questions, for the protection of everyone, please wait 14 days before you and your party join this group.
Are you, or anyone in your party, currently experiencing, or have recently experienced any of the following symptoms: fever of 100.4 F or greater, cough, sore throat, shortness of breath or difficulty breathing, chills, repeated shaking with chills, muscle aches, headache (not attributed to a chronic condition such as a migraine), new loss of taste or change in taste or smell, or any other symptoms of illness? *
Required
Have you, or anyone in your party, been confirmed positive for COVID-19 in the past 14 days? *
Required
Have you, or anyone in your party, been in close contact with anyone who has been confirmed positive for COVID-19 within the past 14 days? *
Required
Have you, or anyone in your party, been in close contact with anyone who is experiencing symptoms of COVID-19 but is yet to be confirmed within the past 14 days? *
Required
Have you, or anyone in your party, traveled out of the country or anywhere by air or have been in a large group setting in the last 14 days? *
Required
By submitting this form, you are agreeing that the provided information is true to the best of your knowledge for you and your party, and you and your party agree to abide by the procedures established by the church to protect all attendees.
A copy of your responses will be emailed to the address you provided.
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