Mercaz Shabbat Tefillah Signup
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Email *
First and Last Name *
If you would like to share your Hebrew name, please share it here.
When do you want to attend *
Required
Child Name(s) aged 2 - 11
Children aged 2-11 should be added below.  Anyone aged 12 and up should fill out their own response form so we can gather vaccination status.
Are you fully vaccinated? (At least 2 weeks since your 2nd vaccine) and willing to sit with other vaccinated people in a non-socially distant fashion? *
Required
Please initial below to attest that you are fully vaccinated (at least two weeks since your last vaccine).
By attending Mercaz you agree to participate in public health contact tracing if requested by public health authorities.  Please initial below to agree to these terms. *
By signing up to attend services, you agree to follow the Mercaz COVID-19 Guidelines.  Please initial below to agree to these terms. These are available at: https://docs.google.com/document/d/1yh78L8ME9W7uW49M17Ls7piV4-fkJ9weUAe3ORa1ZGE/ *
By registering to participate in tefillah with Mercaz, you indemnify and hold harmless Mercaz, Mercaz's landlords, and its board from any and all harm or damage resulting from your attendance at prayer services including any claims based on Covid-19 against [Mercaz and] Mercaz’s landlords.  Please initial below to agree to these terms. *
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