Church Attendance Registration
Name
First Name
Last Name
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Date of Birth
-
Month
-
Day
Year
Date
Are you a Regular Church Member?
Yes
No
How did you hear about our church/service?
Please Select
Friend
Family
Online
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Would you like to receive updates and newsletters?
Yes
No
Have you experienced any COVID-19 symptoms in the last 14 days?
Yes
No
Have you been in close contact with a confirmed COVID-19 case?
Yes
No
Have you traveled internationally in the last 14 days?
Yes
No
I consent to receive communications from the church:
Yes
No
I agree to abide by the church's guidelines and policies:
Yes
No
Submit
Should be Empty: