Service Registration- November 2022

By attending services or events at AJ, all attendees confirm that:

You are fully vaccinated and will have received your booster shot by March 15, 2022.
You have not tested positive for Covid-19 in the past 10 days.
To the best of your knowledge, you have not been in close contact with someone who has tested positive in the past 2 weeks or, in the event of such contact, you have had a negative test no less than 5 days after exposure and are at least 10 days post exposure.
You do not currently have symptoms consistent with Covid-19 including but not limited to fever, cough, shortness of breath, loss of taste or smell.

If you'd like to have a copy of your vaccination card (including booster) on file with AJ for your convenience, please email a photo to
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Please read the agreement above. Have you read, and do you consent to, this agreement? *
Please select the dates you are registering for.  *
NAMES of ALL people attending *
Phone number (in case of contact tracing) *
Email address (in case of contact tracing) *
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