Seekonk Congregational Church - United Church of Christ Worship Registration
By completing this document and registering to attend the upcoming Sunday service, I and those for whom I am registering, attest to the following:

1. We have not had any of the following symptoms in the previous 24 hours and if we do have any within 24 hours before the service we will not attend: Fever (>100.4F), Cough, Sore Throat, Shortness of Breath, Chills, Diarrhea, Loss of ability to smell and/or reduced sense of taste.

2. We have not tested positive for COVID-19 in the last 14 days.

3. We are not actively awaiting a Covid-19 test result.

4. We have not been in contact in the last 14 days with anyone who tested positive for COVID-19, is currently being tested, or has been placed on home quarantine by the Department of Health.

5. We have not traveled from any area currently requiring a 14-day quarantine by MA state regulations.

6. We have all reviewed the SCC-UCC Regathering Guidelines and agree to strictly follow all guidelines as listed.

We also agree that if anyone registered below tests positive for COVID-19 within 14 days of attending service, we will immediately notify the church office for contact tracking purposes.
Sign in to Google to save your progress. Learn more
Email *
Name(s) *
Date of Service You Are Attending *
MM
/
DD
/
YYYY
Phone Number (10 digits only) *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy