COVID-19 Health Declaration & Seat Reservation

Due to very limited seating - and in effort to protect the health and safety of members and visitors - it is required that EVERYONE (both members and visitors) complete this COVID-19 Health Declaration & Seat Reservation survey.

Answer all questions truthfully and to the best of your knowledge.
A new form must be completed WEEKLY for entrance into the sanctuary each Sunday.
If there is a YES response to any question, we invite you to worship with us online until all responses are NO.
Every person in your party must complete an individual form (this includes children who need their own seat).
Form DOES NOT guarantee a seat. Reservations are "first registered, first reserved".
You will receive an email informing you of your reservation clearance.
Form is for Sunday Worship only. Wednesday Bible Study is via virtual streaming.

First Name

Last Name

Have you experienced any of the following COVID-19 symptoms: Fever or chills? Cough? Shortness of breath or difficulty breathing? Fatigue? Muscle or body aches? Headache? Loss of taste or smell? Sore throat? Congestion or runny nose? Nausea or vomiting? Diarrhea?

Yes

Within the past 14 days, have you been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have laboratory-confirmed COVID-19 diagnosis, or with anyone who has any symptoms consistent with COVID-19?

Yes

Are you currently waiting on the results of a COVID-19 test?

Yes

Questions or Comments

Please note:

Names must be confirmed on our reservation list before you are allowed to enter the sanctuary.
Temperatures will be checked prior to entering sanctuary.
Seats are spaced for social distancing.
Sanitizing stations are available.
Masks are available upon request.

TO HELP PREVENT THE SPREAD OF COVID-19, I AGREE TO FOLLOW THE REDEEMING WORD CHURCH COVID-19 GUIDELINES. I HAVE READ, UNDERSTOOD, AND COMPLETED THIS SURVEY TRUTHFULLY. I TAKE RESPONSIBILITY FOR MY ANSWERS AND WILL HOLD REDEEMING WORD CHURCH HARMLESS.

I confirm that the information given in this form is true.

Thank you for submitting your COVID-19 Health Declaration & Seat Reservation survey. Soon, you will receive an email which will inform you if space is available this Sunday.