Children's Worship Registration
Friends, we are now able to welcome children back into the building. In the sanctuary, you will be able to sit with household units, so families stay together. We require masks according to Virginia law. Use this form to register all children under the age of 18 years old.

The nursery will be open for children 4 years old and younger. While we are not ready for Children's Church, we will have packaged kits for each child to help engage them during the service.
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Family Last Name *
Which service are you attending? *
Nursery-aged:  First names of children 4 & younger?
Nursery: Number going to the nursery? *
Children ages 5-17: First names.
The number of activity bags requested. *
HEALTH ACKNOWLEDGMENT FORM
Please respond to the following questions, so we may keep you and other congregants gathering with you safe and healthy. These questions are to screen for persons who could transmit the virus causing COVID-19. The information will remain confidential and reviewed only by your local clergy. The District Superintendent, Bishop/Cabinet, and Department of Health will review only if necessary.
I acknowledge:
1. My child(ren) has not had 2 or more of the following symptoms of COVID-19 in the past 14 days:
   -Fever
   -Shortness of breath or difficulty breathing Chills
   -Persistent cough
   -Flu-like symptoms
   -Diarrhea or intestinal upset
   -Fatigue
   -Sore throat
   -Headache
   -Muscle pain
   -Recent loss of taste or smell
2. We have not been in contact with anyone experiencing symptoms of COVID-19 (identified above) in the past 14 days.
3. We have not tested positive for COVID-19, nor am I awaiting test results, nor have I tested positive and have not subsequently had complete resolution of COVID19 symptoms.
4. I will immediately notify my pastor if after attending In-Person Worship we develop 2 or more symptoms of COVID-19, will avoid contact with others, and will seek medical attention.

I can answer ‘YES’ to all of the above questions for all attending children. *
If you cannot answer ‘YES’ to all of the above, we ask you to wait before attending any in-person gatherings at church until you can answer affirmatively.
Name of person filling out the form.
Email
Phone *
PRAYER SUPPORT
Please share your prayer requests and coordinate a time to talk to one of our ministers.
Prayer Requests
Would you like a follow-up call?
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