J Congregation Registration 5th & 6th grade
Oct. 17, 2020
5th and 6th grade from 9:45-10:45
Name of parent *
Email of parent *
Name of child *
Is your child in 5th or 6th grade? *
Email of child if he/she has. Write none if none. *
I agree to wear a mask and keep social distancing *
Have you or someone you came in contact with traveled outside the U.S. or to any state with high COVID-19 infection rates in the past 14 days? *
Have you had any known close contact with a person who is lab confirmed to have Covid 19 ? *
I acknowledge that I do not have any symptoms of illness, specifically, fever of 100.4°F (38°C) or higher, cough, shortness of breath, sore throat, pneumonia/flu symptoms, headache, body aches, nausea/vomiting, or loss of taste & smell. *
If I have answered Yes to any of the above questions I am NOT eligible to attend an in-person event at Keter Torah *
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