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St John's Church Service Attendance
To be completed as a means of registering for Sunday morning worship
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* Indicates required question
Name and Surname
*
Your answer
ID number
*
Your answer
Email
*
Your answer
Cell Number
*
Your answer
Date of service
*
MM
/
DD
/
YYYY
Fever (high temperature)
*
Yes
No
Cough
*
Yes
No
Sore throat
*
Yes
No
Shortness of breath
*
Yes
No
Myalgia (general weakness)
*
Yes
No
Loss of taste
*
Yes
No
Loss of sense of smell
*
Yes
No
Body aches
*
Yes
No
Redness of the eyes
*
Yes
No
Nausea/vomiting/diarrhoea
*
Yes
No
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