In Person Kulanu TEENS. program ~ Sat. April 17, 2021  @ 11:30AM
Congregation Ohav Shalom will be holding an in-person, Indoor Kulanu TEENS program for grades 6-12 on Saturday, April 17 at 11:30am led by youth leader, Ruth Malka. Join us in person for some "table talk"!

We will host this engaging and interactive program in Ohav's large social hall. All COVID protocols will be observed to include mask wearing and social distancing. As we will be limiting the number of individuals who can attend this service, we REQUIRE all those interested in attending to preregister. Registration DEADLINE is Thurs. April 15 when the registration will close.

Filling out this registration form does not guarantee that you will have a reserved space for the service. You will be notified if you have a confirmed reservation by Thursday April 15.

We appreciate your patience as we continue to work on our strategy for meeting together in person, safely. Thank you for your understanding!
Sign in to Google to save your progress. Learn more
Email *
Untitled Title
Your First Name *
Your Last Name *
Please confirm your email address *
What is the best phone number to reach you at? *
Please enter your phone number as (xxx)-xxx-xxxx. Please use a phone number that can receive text messages.
Are you a member of Congregation Ohav Shalom? *
Will any other individuals from your household be attending with you? *
You may only register those individuals who have been living with you, in your home, for at least the past eight weeks.
If yes, please list the name(s) of those individuals - who have been living with you for at least the past 10 days - who will be joining you. Separate each name with a comma. If you will be attending on your own, please write 'N/A.' *
Neither I nor other individuals from my household (attending the service or not) are currently under quarantine, and I do not have any reason to believe that I or members of my household have had exposure to Covid-19. *
Neither I nor other individuals from my household (attending the service or not) currently exhibit any signs of illness including fever above 99.5F, chills, rash, cough, shortness of breath, sore throat, or loss of smell or taste. *
Neither I nor other individuals from my household (attending the service or not) have traveled outside of the local area during the past two weeks, and will not be traveling outside the local area prior to our Kulanu program on April 17. *
I, and all members of my household who are attending the service, agree to wear a mask, and I/we will bring my/our own mask(s). *
If I am, or other members of my household are, "high risk" (65 and older, immunocompromised, respiratory conditions, diabetes, or those with chronic kidney, lung, or heart disease, or severe obesity), I understand that I am encouraged not to attend an in-person religious service at this time. If I am registering, I have considered and understand the health risks involved to myself and the members of my household. *
I understand that this registration does not guarantee me, or household members that I have registered, a spot at this Kulanu Jr. orogram. I will be notified if I and the registered members of my household have a spot. If I/we do not have a spot, I/we will not attend. *
I understand that if I, and registered members of my household, do not comply with this agreement, I/we will be asked to leave. I understand that if I/we or others do not comply, this and future services may be cancelled until a new plan is in place. *
I understand that should I be able to attend the service, I do so at my own risk and do not hold Congregation Ohav Shalom, its officers, staff, board members or volunteers liable should I contract COVID 19 after attending any service there. *
Electronic Signature. By writing my name here I confirm I have read the above and the information I have provide is true. *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google.