st simon the apostle, ROWVILLE

CATHOLIC CHURCH

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Navigating the reopening
of Church Masses through COVID-19

St Simon's is committed to providing religious services to all (vaccinated and unvaccinated).

In order to assist us to navigate the directions imposed by the Victorian State Government and the Catholic Archdiocese; could you please kindly take just a few moments to fill out this form for all members of your family aged 12 and over who wish
to attend Mass at St Simon's.

Do you agree to provide St Simon's Parish the following
The maximum number of form submissions has been reached. This form is currently not available.
- "sensitive medical information regarding vaccination status"
  
  You are under no obligation to complete this form.
  Our intent is to facilitate, not discriminate the safe reopening of Church Masses for all.
  I Agree Please select this field.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- All data collated from this form will be used and stored in accordance with the Catholic Archdiocese of Melbourne Privacy Policy. Please enter an email address.
- List family members - DOUBLE VACCINATED
- List family members - SINGLE VACCINATED
- List family members - UNVACCINATED (Medical Exemption | Other)
Submit

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