Registration for Yom Ha'atzmaut Kulanu on May 15, 6:00-8:00 pm
We are so glad you are joining us for Yom Ha'atzmaut Kulanu to celebrate Israel! 

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Email *
Name of person filling out this form on behalf of household. *
Phone Number *
How many people in your household are attending? (list # of people) 
 *
Names of people in your household who will be attending (Please indicate the age of each child):
 *
Please include any special dietary needs or allergies (vegetarian, vegan, pescatarian, gluten-free, etc.) of anyone in your household, if applicable. If not, please leave this section blank.
How did you hear about this program? *
In signing my name below, I grant Bet Am Shalom permission to use photos of my family members, including children (neither photos nor captions will contain any names) in synagogue publications, including but not limited to: slideshows used at BAS, Newsletters, Emails, Fliers, BAS Facebook and Instagram Pages, and the BAS website. *
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