+Blessed Sacrament / Adoration Registration

FOR THE HEALTH, SAFETY, AND WELL-BEING OF ALL, PLEASE FOLLOW THESE GUIDELINES:

• FACE MASK – GAITER – NOSE AND MOUTH COVERING MUST BE WORN AT ALL TIMES.
• USE HAND SANITIZER PROVIDED AT THE ENTERANCE OF THE CHURCH, BEFORE ENTERING THE BLESSED SACRAMENT CHAPEL.
• BEFORE LEAVING, USE SANITIZING WIPES PROVIDED TO WIPE DOWN YOUR CHAIR FOR NEXT ADORER.

THANK YOU FOR YOUR COOPERATION!

Blessed Sacrament / Adoration Registration

Date

Attendees 12

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Time

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I confirm that no members of my household and I have had a fever in the past 2 weeks. * I confirm

I confirm that no members of my household and I have a cough or shortness of breath. * I confim

I confirm that no members of my household and I have come into contact with anyone who is COVID-19 positive in the past 2 weeks. * I confirm

I confirm that no members of my household and I are frail because of age or vulnerable because of an underlying condition or are a caretaker of someone who is. * I confirm

I confirm that no members of my household and I are fearful. * I confirm

BY SUBMITTING THIS FORM, YOU CONFIRM THAT YOU HAVE READ AND UNDERSTOOD THE STATEMENTS ABOVE AND MEET ALL OF THE CONDITIONS TO ENTER THE CHURCH * I confirm

Name *

Email *

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