360 Church Service Registration NO ADDRESS • 360 Church

CHURCH SERVICE REGISTRATION

PLEASE READ BEFORE PROCEEDING:

It's important that if you are sick that you stay home today. Please do not enter if:

If you have any symptoms associated with COVID-19 (e.g. fever, cough, sore throat, shortness of breath, sneezing/runny nose or loss of sense of smell, diarrhoea, nausea or vomiting).
If you have been in contact with any known, active case of COVID-19 in the past 14 days.
If you have returned, or been in contact with anyone else who has returned from overseas or has returned from a designated hotspot interstate in the past 14 days.

Personal Information

PLEASE NOTE:

It is a condition of entry due to COVID-19 regulations that all fields are completed
If you are submitting a form for multiple people, it is a condition of entry that you provide individual information for ALL people in your group/family.

First Name *

Last Name *

Gender *

Date of Birth

Email Address *

Mobile Number *

Please select which of the following is most applicable to you: *

New to 360 Church

I Call 360 Church Home

Locations *

360 Church Rockhampton

360 Church Yeppoon

Tip: Please select which 360 Church location you are attending today

For those who are New To 360 Church or Who Call 360 Church Home, the information you provide on this form will be used by 360 Church to be in touch with you and to provide updates and where relevant, provide pastoral care. You can change your mind at any time by clicking the unsubscribe link in the footer of any email you receive from us, or by contacting us at mail@360church.com.au.

I understand that I can find the 360 Church Privacy Policy on the INC website at https://www.inc.org.au/privacy/ * *

Yes