Friday Night Service Registration - Form - Temple Beth Am of Northern Westchester

* Email address

* First Name

* Last Name

Your answers to all of the following questions apply to you and to any other family members you register below. If you register for a future service and any answers change as to make you ineligible, please notify us immediately. Please register prior to services.

* Has anyone had any signs of Covid in the last 48 hours?

Please Select OneYesNo

* Has anyone been in contact with anyone in the last week who tested positive for Covid in the last 14 days?

Please Select OneYesNo

* Has anyone tested positive for Covid in the last 14 days?

Please Select OneYesNo

We regret that under the current circumstances, you are not yet eligible to attend in-person services at this time. You are welcome to attend remote services via the zoom links emailed weekly to each member. We look forward to your joining us soon!

* Anyone who cannot provide proof of vaccination agrees to wear a face mask within the building at all times regardless of vaccination status

Please Select Oneagreedo not agree

* Any children in our group will not leave their seat during the service, except in case of emergency

Please Select Oneagree or no children in groupdo not agree

We regret that if you cannot agree to the conditions above, you are not yet eligible to attend in-person services at this time. You are welcome to attend remote services via the zoom links emailed weekly to each member. We look forward to your joining us soon!

Everything looks good! Just answer the next few questions and hit "submit" on the bottom.

Below next to the date of the service you wish to attend, click on the arrow and select the number of people (up to 6) in your group (including yourself) who wish to attend. If you do not make any selections, it will be assumed you do not want to reserve any seats and your entry will not be submitted or saved.

* Service Date(s) and Number of Seats

September 24 at 7:30pm - 18 of 35 LeftA selection is required for your entry to be submitted