Register for Mass - Sundays at 10:30 - Church of St. Timothy

Please complete information for each person in your household that will be coming to Mass at 10:30 on Sunday morning in the church, including children aged 2 and over.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Does the person use a wheelchair or walker? REQUIRED Yes No Please fill out this field.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Number of additional household members REQUIRED
Please enter the number of additional household members who will be sitting with you at Mass.
Please fill out this field.
Additional household member 1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Does this person use a wheelchair or walker? REQUIRED Yes No Please fill out this field.
Additional household member 2
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Does this person use a wheelchair or walker? REQUIRED Yes No Please fill out this field.
Additional household member 3
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Does this person use a wheelchair or walker? REQUIRED Yes No Please fill out this field.
Additional household member 4
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Does this person use a wheelchair or walker? REQUIRED Yes No Please fill out this field.
Additional household member 5
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Does this person use a wheelchair or walker? REQUIRED Yes No Please fill out this field.
Additional household member 6
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Does this person use a wheelchair or walker? REQUIRED Yes No Please fill out this field.

By registering for a seat at Mass you are agreeing that all household members will follow all policies as outlined by St. Tim's, including but not limited to: wearing a mask over your mouth and nose, refraining from singing, refraining from shaking hands, maintaining social distancing, being seated by an usher in a location chosen for you.

I Agree Please select this field.