Please fill this out 2 – 4 hours prior to each event you plan to attend.

What type of event will you be attending?
Neither myself or anyone in my household has had any of the following symptoms in the last 14 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever of 100.4 degrees or greater
In the last 14 days, neither myself or anyone in my household has been to a large gathering (indoor or outdoor) where social distancing was not feasible
I agree to immediately let BRPC know if any of the information on this form changes. Given the current pandemic I understand that there are inherent risks associated with being present at the Basking Ridge Presbyterian Church and agree to assume all risks associated with it. I also agree to let the church know immediately if I am diagnosed with COVID-19 following this event