CBAJ Selichot Kumzits and Service

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Please use this form to register for CBAJ's Selichot Program. It will take place in the CBAJ Parking Lot on Saturday Night, September 12, at 9:15 pm, weather permitting. Selichot Service will take place at 10 pm rain or shine.

Email *

Name *

Cell phone number for last minute Text Message update *

I am a CBAJ Member *

Yes

Please list names of people in your party

I/We would like to attend: *

Kumzits at 9:15 pm. Please park on the outer perimeter of the parking lot to allow for the Kumzits to take place in the center. Kumzits will not take place if it's raining. Please bring your instrument!

Selichot Service at 10 pm. Outdoors (indoors if raining).

Required

I (and anyone attending with me) am not currently under quarantine, am not required to quarantine by NY State based on where I have traveled, and I do not have any reason to believe that I have had a clear exposure to Covid-19. I am also not currently exhibiting any signs of illness (including fever, chills, rash, cough, shortness of breath, sore throat, or loss of smell or taste). *

Agree

Disagree

We (and anyone over 2) agree to wear a mask while attending the program. We will bring our own mask. *

Yes

I understand that if I do not comply with this agreement, I will be asked to leave. I understand that if I or others do not comply, this and future services may be cancelled until a new plan is in place. *

Agree

Disagree

Electronic Signature. By writing my name here I confirm I have read the above and the information I have provide is true. *

A copy of your responses will be emailed to the address you provided.

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