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Register Here for Reentrance

How are you feeling today?

1. Has anyone listed returned from travel within the last 14 days? Required *

Yes

2. Have you or a Household family member had close contact with, or cared for Anyone diagnosed with covid-19 within the last 14 days? *

Yes

3. Has Anyone listed experienced any cold or Flu-like symptoms in the last 14 Days? (FEVER, COUGH, SORE THROAT, RESPIRATORY ILLNESS, DIFFICULTY BREATHING, LOSS OF TASTE OR SMELL, MUSCLE, BODY ACHES)? *

Yes

4. Does anyone Listed have a Temperature above 100.4? *

Yes

REGISTRANT 1

First Name

Last Name

Phone

Select an option *

Single

Family

Select Person

Member 1 Name

Member 1 Phone

Member 1 Email

Member 2 Name

Member 2 Phone

Member 2 Email

Member 3 Name

Member 3 Phone

Member 3 Email

Member 4 Name

Member 4 Phone

Member 4 Email

Member 5 Name

Member 5 Phone

Member 5 Email

VACCINE SURVEY

PEOPLE ARE CONSIDERED FULLY VACCINATED

2 WEEKS AFTER THEIR SECOND DOSE IN A 2-DOSE SERIES, SUCH AS THE PFIZER OR MODERNA VACCINES,

2 WEEKS AFTER A SINGLE-DOSE VACCINE, SUCH AS JOHNSON & JOHNSON’S JANSSEN VACCINE

NOT APPLICABLE

BEST WAY TO REACH YOU

Phone Number

All adults listed on this form must have a signature above. Digital Signatures will be accepted.

Adult Digital Signature Full Name

We are sorry, you did not meet the "In-Service Requirements". Please continue to tune-in every Sundays starting at 3:00PM EST on Facebook | YouTube

Reservation Confirmed! You have successfully submitted your registration for Sunday Morning Worjship at 11AM.

Sunday

9:00 AM Early Morning Woship Experience

11:00 AM Sunday Worship

9:45 AM Sunday School

Wednesday

6:00 Inercessory & Corporate Prayer

6:20 PM Bible Study (1st & 3rd Wednesday)

Service Times

Visit Us

19130 Beaconsfield St.

Detroit, MI 48224

Office (313) 371-6609

Office Hours: By Appoinment

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