Blawenburg
Reformed Church
In Service to the Risen Christ Since 1832
Welcome to In-Person Worship
The help ensure the safety of all who attend the service, the following policies have been implemented:
A mask must be worn properly (covering both mouth and nose) at all times. Failure to do so will result in the cancelation of the service.
We will not be singing and there will be no responsive readings.
Please sit in a seat that is available and remain there during the entire service.
You are attending this service at your own risk. We ask that you please fill out the following questionnaire and take the Covid 19 Illness Notification card with you.
Name ________________________________________________ Date___________________
Address ______________________________________________________________________________
Contact information
Phone ______________________________________________________________________________
Email ______________________________________________________________________________
Are you currently experiencing any symptoms such as fever, cough, runny nose, feel ill? (Please circle your answer)
YES NO
Have you traveled outside New Jersey in the last 10 days? (Please circle your answer)
YES NO
Have you had any exposure within the last 10 days to a person with known Covid 19? (Please circle your answer)
YES NO
Please note that if someone attending today develops Covid 19 within the next 10 days we will notify you so that you might take the necessary precautions.
Signature __________________________________________________