Youth and Confirmation Sunday Seat Reservation

Youth & Confirmation Sunday In-Person Worship Risk Acknowledgement

To join us for worship on May 23, 2021, please first fill out the risk acknowledgement form, below. Once you hit "submit," you will be taken to the webpage to choose your seats (you will need to enter your email address again). For questions, please contact Jessica at jthurnes@wpc-alex.org.

Name*
First Last
Email*
Other Household Member(s), if applicable:
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- I confirm that neither I, nor anyone in my immediate household who is or is not attending with me, are exhibiting COVID-19-like symptoms, such as fever, loss of taste or smell, chest tightness, fatigue, cough, nausea or vomiting, sore throat, shortness of breath or difficulty breathing, etc.
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- I will refrain from attending services if I am aware that I have had contact with anyone who has tested positive for COVID-19 within the past 14 days. 
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- I will bring my own face covering with me and will wear it the entire time while on church property (ages 2 and older). 
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- I will voluntarily social distance (maintain a 6-foot separation from another person not in my immediate household) while on church property. 
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- I will comply with posted signage and direction from ushers.
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- I understand that if I do not comply with the protocols listed above, I will be refused entry or asked to leave the service.
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- I will notify church staff if I test positive for COVID-19 within two weeks of attending an in-person worship service or church event. 
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- I acknowledge COVID-19 is highly contagious; if contracted it can cause severe illness ,long-term health conditions or even death, especially for older adults and those with underlying medical conditions; it can be contracted even if all preventive measures are followed; and attending in-person worship services could increase my risk and my household’s risk of contracting COVID-19.
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- I fully understand all of the risks (including those listed above) and fully and freely assume the risk that I or my household may be exposed or infected by COVID-19 because of the actions, omissions, or negligence of myself or others while on church property.
Phone
This field is for validation purposes and should be left unchanged.