Registration for In-Person, Indoor Shorashim -  3/13/2022, 10:00 - 11:00 AM
This month's theme is Purim.

All attendees ages 5 and above must submit proof of full vaccination by 12 PM on Friday, March 11.
A photo of the vaccination card OR a screenshot of the NY State Excelsior Pass which certifies your vaccination must be sent to betamshalom@betamshalom.org. If you have already submitted it, no need to resubmit it.

Everyone must be masked at all times and should socially distance.
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电子邮件地址 *
Name of person filling out this form on behalf of household.   *
Phone Number *
How many people (𝗶𝗻𝗰𝗹𝘂𝗱𝗶𝗻𝗴 𝘆𝗼𝘂𝗿𝘀𝗲𝗹𝗳) in your household are attending? (Put # Here) *
Names of all people in your household who will be attending, 𝗶𝗻𝗰𝗹𝘂𝗱𝗶𝗻𝗴 𝘆𝗼𝘂𝗿𝘀𝗲𝗹𝗳. (Please put the ages of children in parenthesis). *
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. *
How did you hear about this event?
All participants above the age of 5 must provide documentation that they are fully vaccinated to betamshalom@betamshalom.org. *
您回复的副本将通过电子邮件发送到您提供的地址。
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