COVID-19 FORM | BOOM

IF YOU WOULD LIKE TO VISIT US PLEASE, FILL-OUT & SUBMIT COVID FORM PRIOR TO ARRIVING

PLEASE DO NOT SUBMIT EARLIER THAN THE DAY BEFORE YOU PLAN TO VISIT

Covid-19 Health Declaration

For the protection of our congregants, each visitor/member is required to fill out a COVID-19 questionnaire, must have answered “No” to all questions, and GIVE permission to take your temperature prior to entering our location.

First Name

Last Name

Phone

Date

To the best of my knowledge: (If you can not answer "NO" to any of the questions, see below #5 and respond promptly)

1. You have NOT been within 6 feet of an infected person, for a total of 15 mins. or more, over a 24-hour period, starting from two days before illness onset.

2. You have NOT knowingly been in close or proximate contact in the past 14 days with anyone who has tested positive for COVID-19 or who has had symptoms of COVID-19.

3. You have NOT tested positive for COVID-19 in the past 14 days.

4. You have NOT experienced symptoms of COVID-19 in the past 14 days (i.e., cough, fever, chills, muscle pain, shortness of breath or difficulty breathing, sore throat, new loss of smell).

5. In the past 14 days, you have NOT traveled internationally or to any US state subject to a CDC or New York mandatory quarantine order upon returning.

IF YOU CAN NOT CHECK ANY OF THE QUESTIONS ABOVE PLEASE, DO NOT SUBMIT FORM AND CONTACT A SENIOR PASTOR IMMEDIATELY AT THE NUMBER LISTED BELOW, SO THAT WE COULD PRAY FOR YOU AND STAY INFORMED OF YOUR CONDITION.

CONTACT PASTORAL CARE: 1.888.263.9631, EXT.# 1

Thanks for submitting, stay blessed!

WATCH THE FIRST EVER MULTI-SEASON SERIES ABOUT THE LIFE OF CHRIST

IF YOU WOULD LIKE TO VISIT US PLEASE, FILL-OUT & SUBMIT COVID FORM PRIOR TO ARRIVING

PLEASE DO NOT SUBMIT EARLIER THAN THE DAY BEFORE YOU PLAN TO VISIT

Covid-19 Health Declaration

To the best of my knowledge: (If you can not answer "NO" to any of the questions, see below #5 and respond promptly)

CASH APP:

$BodyofoneNYC

boomnyc

ylboomnyc

Our Live will be available on Facebook and YouTube immediately after worship

"May God our Father and the Lord Jesus Christ give you grace and peace" - 2 Thess. 1:2

IF YOU WOULD LIKE TO VISIT US PLEASE, FILL-OUT & SUBMIT COVID FORM PRIOR TO ARRIVING

PLEASE DO NOT SUBMIT EARLIER THAN THE DAY BEFORE YOU PLAN TO VISIT

Covid-19 Health Declaration

To the best of my knowledge: (If you can not answer "NO" to any of the questions, see below #5 and respond promptly)

CASH APP:

$BodyofoneNYC

boomnyc

ylboomnyc

***Our Live will be available on Facebook and YouTube immediately after worship***

"May God our Father and the Lord Jesus Christ give you grace and peace" - 2 Thess. 1:2

Our Live will be available on Facebook and YouTube immediately after worship