In-Person Service Registration - Form

* First Name

* Last Name

* Email

* Are you fully vaccinated?

Please Select OneYesNo"Fully vaccinated" means it has been 2 weeks since your second dose of Moderna or Pfizer, or 28 days after your single dose of Johnson & Johnson

If you are not yet fully vaccinated, when do you expect to be?

* What was the date of your final vaccine appointment, or when is it scheduled for?

* Was that appointment for a vaccine requiring 2 doses (eg Moderna/Pfizer) or 1 dose (eg Johnson & Johnson)?

Please Select One1 dose2 doses

* Are you able/willing to read Torah?

Please Select OneYesNo

* I am registering only for myself. Anyone who wishes to attend with me will fill out this form themselves after submitting the In-Person Service Screening Form (available above)

I am registering only for myself. Anyone who wishes to attend with me will fill out this form themselves after submitting the In-Person Service Screening Form (available above)

NOT-YET-FULLY VACCINATED SLOTS

Please select slots in this section ONLY if you will not yet be fully vaccinated for the selected service/s (service date is less than 14 days after receiving your 2nd dose of Pfizer or Moderna, or 28 days after receiving your single dose of Johnson & Johnson)

Morning Services (not-yet-fully vaccinated slots)

Services start at 9:45am

Kabbalat Shabbat Services (not-yet-fully vaccinated slots)

Services start at 6:30pm

Sunday Morning Minyan Services (not-yet-fully vaccinated slots)

Services start at 8:30am

Is there a personal reason - such as a yahrzeit, birthday or anniversary - that makes any of these dates special for you?

FULLY VACCINATED SLOTS

Please select slots in this section ONLY if you will be fully vaccinated for the selected service/s (service date is at least 14 days after receiving your 2nd dose of Pfizer or Moderna, or 28 days after receiving your single dose of Johnson & Johnson)

Morning Services (fully vaccinated slots)

Services start at 9:45am

Kabbalat Shabbat Services (fully vaccinated slots)

Services start at 6:30pm

Sunday Morning Minyan Services (fully vaccinated slots)

Services start at 8:30am

Is there a personal reason - such as a yahrzeit, birthday or anniversary - that makes any of these dates special for you?