COVID-19 Synagogue Registration Form
Please keep in mind the Rules and Regulations shown below when registering to come to the Synagogue.

Due to the current situation, in order to pray in our Synagogue everyone must be registered until further notice.

Please be advised of the mandatory 14 days quarantine requirement for anyone that has traveled and/or arrived from outside of the State of Florida.
Email address *
Full name (First Name Last Name) *
Age *
Phone Number *
Home Address *
Are you planning to come with someone else from your family? Please give us their name and age as well. *
Have you traveled in the last 14 days? *
If you traveled in the last 14 days, when did you arrive in Miami? *
Have you or anyone in your family been diagnosed with COVID-19? *
Have you been tested for COVID-19 and Antibodies? Please explain. *
A copy of your responses will be emailed to the address you provided.
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