Thank you for registering for services. Please fill this form out for one person only.
If there is anyone else in your party, they must have a separate form completed so we can keep track of vaccination status.

If you are completing this form after 11:00 am on Friday and it is your first time providing proof of vaccination, please bring your vaccine card with you to services in addition to completing this form.

We require everyone attending services or other events in-person to pre-register and to provide proof of up-to-date vaccination (including boosters to the extent eligible). This includes service leaders, greeters, shomrim, and anyone else with a role in services. 

We also require everyone inside the building to wear a mask, with limited exceptions, such as when delivering a drash, leading part of the service, or while eating. Our goal is to keep Covid out of our community to the extent possible. 

And finally, if you are not feeling well or develop symptoms after you have registered to attend, or you have been exposed to someone who is infected since registering, please stay home. Get tested and, if you test positive, please don’t come to the synagogue for 10 days. 

If you attend services and subsequently develop symptoms or find out you have been exposed to someone who is infected, please notify Rabbi Werbow right away.