COVID-19 Synagogue Registration Form Oct 2020

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Please keep in mind the Rules and Regulations shown below when registering to come to the Synagogue.

Due to the current situation, in order to pray in our Synagogue everyone must be registered until further notice.

If you are coming from out of state, please contact the office after filling out this form for further instructions.

Email *

Last Name *

First Name *

Age *

Phone Number *

Home Address *

Are you planning to come with someone else from your family? Please give us their name and age as well. *

Have you or anyone in your family been diagnosed with COVID-19? *

Yes

Have you been tested for COVID-19 and Antibodies? Please explain. *

Will your be joining us from out of state? *

Yes