Erev Shabbat Registration

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* First Name

* Last Name

* Email

* Cell Phone

Date of Shabbat Service

How Many are Attending with You?

* Names of those Attending

Please answer the following questions. If any of the answers is "YES" you will not be able to attend services. If you answer "NO" and before services this changes to "YES" please contact the Temple office to remove you from the attendee list.

* Have any of the attendees had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days?

YesNo

* Have any of the attendees experienced any of the following symptoms in the last 14 days: fever, cough, shortness of breath, loss of taste or smell, or other respiratory problem?

YesNo

* Have you traveled to any of the states on the NJ Travel Advisory List over the last 14 days?

YesNoClick here for travel advisory list

Fri, December 4 2020
18 Kislev 5781

Fri, December 4 2020 18 Kislev 5781