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6pm Service 19 September 2021
Welcome! We are looking forward to seeing you at St Stephens on Sunday.
Please do not come if you are feeling in any way sick or compromised.
PLEASE FILL IN 1 FORM PER PERSON including babies as this allows us to count heads for the government regulated numbers per service.
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* Indicates required question
Government regulations require churches to perform basic Covid-19 screening before allowing people access into their buildings.
Please answer the following questions truthfully
Are you experiencing any of the following symptoms? Fever, Cough, Body Aches, Nausea or Vomiting, Sore Throat, Shortness of breath, Loss of taste and smell, Diarrhea, Fatigue/ Weakness/Tiredness?
*
Yes - Please note that you should isolate and seek healthcare advice if you are experiencing these symptoms.
No.
I understand that my visit will potentially expose me to people who might be carriers of Covid-19. I understand the risk I am personally taking by entering the building and taking part in the service. I will not hold St Stephens Bible Church, their staff, the church council or REACHSA liable for any infection or illness that occurs as a result of my attendance. I understand that I will be required to wear a mask throughout the service. I also understand that I will be required to keep to social distancing guidelines.
*
Yes
No (Please note, that if you choose no, you will not be allowed onto the Church premises as per government regulations)
Who is attending the service?
First Name (1 person per form)
*
Your answer
Surname
*
Your answer
Contact Number
*
Your answer
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