In-Person Worship Service Check In

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Checking in for this service allows us to contact you in the case of any exposure to COVID-19 at Wy'east UU In Person Worship Service at the Center for Positive Aging. This form can be completed in advance of the service to save time or you can complete it online when you arrive. Please read the protocols outlined below and answer the questions. Thank you for protecting our community.

We will adhere to the safety protocols outlined by the Community for Positive Aging. If you are unwilling or unable to meet the safety protocols noted, please do not attend our service in-person.

Vaccination required (see details below)
Masks at all times
No food or beverages
Doors will be locked. A greeter will check RSVP status and open the door as guests arrive.
We will only admit people through the front door, on 40th Ave.

I am checking in for the worship service happening on *

YYYY

Please list all names of the people in your household attending. *

What email should we use in case we need to contact you? *

I affirm that none of us have had symptoms of COVID or known exposures to COVID in the last 2 weeks AND that none of us are currently waiting for results from a COVID test. *

Yes

Other:

If you are a return guest and have completed this form previously, you may stop here. First-Time guests, please complete the following questions for contact tracing purposes.

If you are here with children who may attend the religious education class during service, please indicate their ages. Children are also welcome to stay in service with you.

I affirm that everyone over the age of 12 has had at least two COVID vaccine doses, or one Johnson and Johnson dose.

Yes

Other:

Clear selection

I understand and affirm that all of us (except children under 2) are expected to cover our noses and mouths at all times with a mask while in the building.

Yes

Other:

Clear selection

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