First Baptist Church of Merrifield Service Attendance Form
To schedule service time, please fill out the information below.
Attendance Details
Select date on the calendar below and click on 10:00 AM over to the right. Use the arrow to move to the next month. If a Sunday is gray that means it has reached capacity. You can choose to select another Sunday or visit us for online services.
*
Contact Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Best method for contacting you?
*
Please Select
Email
Phone
Best time of day to reach you?
Please Select
Morning
Noon
Afternoon
Evening
Night
Are you fully vaccinated?
*
Yes
No
Do you agree to adhere to the COVID-19 guidelines as implemented by First Baptist Church of Merrifield? You can find these procedures on the church website.
*
Yes
No
Have you experienced any COVID-like symptoms in the last ten days?
*
Yes
No
List any additional information that you would like for the FBCM Task Force to consider at this time.
Submit
Should be Empty: