Shabbat Under the Stars
We want to ensure that our gathering is as safe and healthy as possible. Please answer these questions prior to NOON on Friday of the service to expedite entry to the service.
Email address *
Name of Guest One
Name of Guest Two
Name of Guest Three
Name of Guest Four
Name of Guest Five
In the past 14 days has anyone in your group been in close contact with someone with COVID 19? *
In the past 14 days has anyone in your group had a Fever (over 100.4 F w/o medication) , Headache, Chills, Loss of Taste or Smell, Repeated Shaking or Chills? *
In the past 14 days has anyone in your group had a cough? *
Within the past 14 days, has anyone in your group traveled to any of these states? Alabama, Alaska, Arkansas, Colorado, Delaware, Florida, Georgia, Guam, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Puerto Rico, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, Wyoming or Out of the Country (list updated 10/13/2020) *
If you have answered "YES" to any of these questions, please enjoy services from the comfort of your home. We look forward to seeing you at a future in-person service in the near future!
Are you still planning to attend? *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy