Please fill out a separate form for every individual attending from your household

By completing this form, you are indicating that you intend to attend in-person worship on the date listed in the title of this survey, and a space will be reserved for you. The survey will close automatically if/when our maximum occupancy has been reached.

If you do not agree to all of the items below, we are unable to welcome you to in-person worship at this time, but welcome you to continue worshipping weekly with us online, via our YouTube channel.

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For in-person service at this time, we require: online preregistration, entry through the main hall (upstairs), mandatory masks while indoors, sanitizing hands when entering, liability waiver signed by every participant, maximum 50 people, continuous airflow with doors propped open, 45 minute service, outdoor coffee and conversation after worship, individual communion kits that can be taken home and brought back to reuse.

Do you agree to follow all of these protocols while on the Trinity Lutheran Church property?

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First and Last Name

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Phone Number

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We are unable to welcome anyone who:

Has symptoms of Covid-19 (fever, chills, cough or worsening of chronic cough, shortness of breath, sore throat, runny nose, loss of sense of smell or taste, headache, fatigue, diarrhea, loss of appetite, nausea or vomiting, muscle aches, stuffy nose, pink eye, dizziness, confusion, abdominal pain, skin rashes)

Has been in close contact with any person who has been diagnosed with Covid-19

Has travelled internationally within the past 14 days

Is awaiting results of a Covid-19 diagnostic test

Do you agree not to attend, should any of the above apply to you on the date of worship?

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In order to love my neighbours in worship, I agree to wear a mask, and to refrain from passing or sharing items, at all times that I am on the church property.


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I am willing to sign a "Release, Waiver of Liability and Assumption of Risk Agreement" form when entering the TLC building.

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After worship we will offer an optional gathering outdoors for coffee and conversation.

Anyone who would like to stay may remove their mask to drink coffee, eat treats, and visit with one another while maintaining a 6-foot distance. Participants are also welcome to keep their mask on and just visit. Some chairs will be provided.

You may bring your own lawn chair if you prefer.

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