Adat Yeshurun Minyan Questionnaire - Shabbat and Weekday (06-19 through 06-26)
Email address *
First Name *
Last Name *
I agree to wear a mask at all times during services *
Are you committed to keeping 6ft of distance from others? *
Are you currently saying Kaddish? *
Am experiencing any of the following symptoms: *
To the best of your knowledge, have you been in contact with someone who has tested positive for COVID-19 in the last 14 days? *
Have you traveled in the last 14 days? *
If you are in the "High-Risk" category (i.e. over 65 or with underlying health risks/concerns), have you received permission from your doctor to attend services? *
Are you committed, Bli Neder, to attending the service(s) I sign up for at Adat Yeshurun? *
Are you committed to bringing your own Talis, Teffilin, Siddur, Chumash etc. to services? *
Are you committed to coming to the services you select for the sole purpose of prayer? (meaning- NO socializing or gathering) *
Select which of the following minyan you are committing to attending: *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy