SS COVID-19 Form — Archived Website

Sunday School Covid-19 Form

To ensure the safety of students and staff, please fill out this form before bringing your kids to Sunday School. Just a few, short questions and you’re ready to go! Email our Director, Chelsy Haynes, at calstgkids@calstg.org if you have any questions.

Name of Child

First Name

Last Name

Parents Names

Have you or your child knowingly been in close contact (within 6 feet for at least 10 minutes) in the past 14 days with anyone who has tested positive for COVID-19 or who has had symptoms of COVID-19?

In the past 10 days, have you or your child gotten a lab-confirmed positive result from a COVID-19 diagnostic test (not a blood test) that was your first positive result OR was AFTER 90 days from your previous diagnosis date?

Have you or your child experienced any symptoms of COVID-19, including a fever of 100.0 degrees F or greater, a new cough, new loss of taste or smell or shortness of breath that started in the past 10 days?