Mass Registration at Divine Mercy, May 23rd at 8:30AM

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E-post *

Name #1 Last Name, First Name *

Name #2

Name #3

Name #4

Name #5

Do you or anyone in your household have any Coronavirus symptoms? ex. fever, cough difficulty breathing, loss of taste or smell, etc. *

Yes

Have you or anyone in your household had contact with anyone who has been diagnosed with or may have symptoms associated with COVID-19? *

Yes

I understand and agree that I will wear my mask throughout mass *

Yes

Obligatorisk

I understand and agree that I will be assigned a spot and I will remain in this spot for the duration of mass except to receive communion. *

Yes

Obligatorisk

I will practice social distancing and be attentive to the signage and the direction of the attendants, ushers and parish staff. *

Yes

Are there any special considerations we need to know about? ie: need to sit in the back, need to sit in front, uses a wheelchair, etc

Do you plan to receive communion on the tongue? *

Yes

If needed would you be agreeable to be seated in the choir loft? *

Yes

When the Church is full, would you be willing to sit in the Parish Hall from time to time.

Yes

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Formuläret skapades på Roman Catholic Diocese of Syracuse. Anmäl otillåten användning