Sign In
Forgot Password
or Sign In With
Powered By
ShulCloud
Login
New User:
Register Now
Home
Donate
Home
About Us
Contact Us
Services
Donate
Home
Donate
Teacher Appreciation and May Birthday Shabbat
Please verify reCaptcha before submitting the form.
This form is part of our beta-testing of our new CNT website. Please disregard any information not part of this form.
*
First Name
*
Last Name
*
Email
Phone Number
*
I wish to attend Friday night services on:
Friday, May 14th
Total number of people attending
*
If I had any of these symptoms, I attest (both are required for entry):
I have quarantined for at least 10 days from the start of symptoms.
It has been at least 3 days since the symptoms completely resolved.
Not Applicable
*
Have you had any of the following symptoms (check all that apply):
Fever above 100
Unusual Tiredness
New Onset of Cough
Aches & Pains
Sore Throat
Diarrhea
Loss of taste or smell
None of the above
*
I attest that I have NOT had direct contact with anyone known COVID-19 unless I was appropriately using personal protective equipment (PPE).
I attest that I have NOT had direct contact with anyone known COVID-19 unless I was appropriately using personal protective equipment (PPE).
*
* I have NOT tested POSITIVE to any COVID-19 test within the past 10 days.
* I have NOT tested POSITIVE to any COVID-19 test within the past 10 days.
*
* I understand that by reserving a space that I am agreeing to follow the guidelines and restrictions that Congregation Ner Tamid's Covid-19 Task Force is requiring.
* I understand that by reserving a space that I am agreeing to follow the guidelines and restrictions that Congregation Ner Tamid's Covid-19 Task Force is requiring.
Notes (seating choices for example)
Tue, April 23 2024 15 Nisan 5784