Worship Registration Form - Metropolitan SDA Church

INTRODUCTION

Welcome to our online registration form! Please fill out the form in its entirety in order to be able to join our Worship service in person, based on the answers you provide.

This form is one per family and must be filled out only by a parent or a guardian.

The church will OPEN its doors for everyone at 10:30AM
ONLY REGISTERED individuals can attend our in-person Worship service at this time, until further notice
MAXIMUM attendance allowed: 80 people
We will provide Livestreaming for everyone who decides to stay home

SECTION 1 : INITIAL SCREENING

Have you or anyone in your household had a fever greater than or equal to 100.1 in the last 24 hours? Yes No

Have you or anyone in your household had a Recent/New onset of loss of taste or smell? Yes No

(Recent/New) Have you tested positive for Covid-19 in the last 14 days? Yes No

SECTION 2 : ADDITIONAL HEALTH SCREENS

Select symptoms that you or anyone in your household are experiencing at this time Recent/new onset coughing (not related to allergy or COPD) Recent/new Nasal Congestion (not related to allergies or sinus infection) Recent/new onset sore throat Recent/new Shortness of breath (not related to chronic disease) Recent/new onset diarrhea Recent/new onset Nausea/Vomiting Recent/new onset Fatigue/Malaise No one in my household have any of the above listed symptoms at this time

SECTION 3 : IN-PERSON WORSHIP GUIDELINES

These guidelines will be utilized by Metropolitan SDA Church as we gather in the church campus for worship.

1. High-Risk Individuals: All individuals that fall within the high-risk group as defined by the CDC and those who have the symptoms of common flu or allergies are encouraged to stay at home and worship online.

2. Practice Social Distancing: We must always maintain at least 6 feet of separation, according to the CDC guidelines.

3. Sanitary:

surgical mask
face shield
N95
KN95
3 layered Cloth face mask or cloth mask with filter
If you want to wear a face shield, you will still need mask

4. Hand to Hand Items:

SECTION 4 : FAMILY INFORMATION

Full Name of Parent or Guardian

Address (Street, City, State, Zip Code)

Email of Parent or Guardian

Phone Number of Parent or Guardian

SECTION 5 : ATTENDEE REGISTRATION

Number of Adults attending

Number of Children Under 18yo attending

List Full Names of Adults, separated by comma

List Full Names of Children, separated by comma

When Are You Attending the Program/Event?

When Are You Leaving the Program/Event?

SECTION 6 : AGREEMENT

By completing this questionnaire, I affirm that I am at least 18 years of age and that the answers I have provided above are accurate. I agree to follow all the required safety guidelines mandated by the Metropolitan Seventh-Day Adventist Church. As an adult or head of the family, I will be responsible with my household, especially my child/children during the church service. I recognize that by attending our services will lead to possible chance of contacting any transmissible diseases, particularly COVID-19. I will be responsible for my household’s actions; therefore, I release the church or the organization from any liabilities that would result from any actions.

By checking this box and submitting this form, I am electronically signing the pre-screening form.

Type your Full Name to sign electronically

Manually type today's date