BETHEL REFORMED CHURCH
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Due to COVID-19 Regulations, attendance will be capped at 25 people.
Movie Night Pre-Registration
*
Indicates required field
Name
*
First
Last
Names of others in your household who plan to attend the movie night:
*
Email
*
Phone Number
*
Are you currently experiencing any of these symptoms?
- Fever and/or chills
- Cough or barking cough (other than known causes/conditions)
- Shortness of breath (not related to asthma or other known conditions)
- Sore throat (not related to season allergies, acid reflux, or other known conditions)
- Difficulty Swallowing (not related to other known causes or conditions)
- Runny or stuffy/congested nose (Not related to seasonal allergies, being outside in cold weather, or other known causes or conditions)
- Decrease or loss of taste or smell (not related to seasonal allergies, neurological disorders, or other known causes or conditions)
- Pink eye
- Headache (not related to tension-type headaches, chronic migraines, or other known causes or conditions)
- Digestive issues like nausea/vomiting, diarrhea, stomach pain (not related to IBS, menstrual cramps, or other known causes or conditions)
- Muscle aches
- Extreme tiredness
- Falling down often (for older people)
Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?
In the last 14 days, have you or anyone you live with travelled outside of Canada?
In the last 14 days, have you been identified as a "close contact" of someone who currently has COVID-19?
Has a doctor, health care provider, or publiv health unit told you that you should currently be isolating (staying at home)?
In the last 14 days, have you received a COVID Alert exposure notification on your cell phone?
If you answered "yes" to any of the above, you will not be able to attend this event.
*
None of the Above
Submit
Home
Worship
Sermons
>
Manuscripts
Videos
Ministries
Adult
Young Adults
Student
Children
>
Dwell KIDS
Westover Layettes
Our City
Global Mission
Staff
Our Team
Resources
Latest Happenings
Connect