Shabbat Minyan Registration Form

Chabad Synagogue Registration Form
As we re-open our Synagogue, we are taking precautions to have our Minyan in a safe and healthy way.

All participants are required to register for the Minyan in advance.

All participants are required to wear masks and adhere to social distancing policies at the Minyan.

Please fill out the below form to register for upcoming Minyans or events.

By filling out this form, we will be counting on you to be at the Minyan as one of our 10.
I am registering for this event:*

Friday, March 19th, Mincha 6:50 PM, Followed by Kabbalat Shabbat. Shabbat, March 20th, Shacharit Service at 10:00 AM Shabbat Mincha at 6:55 PM Followed by Maariv & Havdalah
Full Name*

First Name Last Name
E-mail*
I would like to receive news and updates by email
Phone Number*

Area Code Phone Number
Please confirm:*

I have NOT been in contact with a confirmed coronavirus patient in the last 14 days. I have NOT traveled internationally or domestically in the last 14 days. I, or someone in my household, did NOT display any of the following symptoms in the last 14 days: Fever, Sore Throat, Dry cough, Runny nose, Body aches, Fatigue, Headaches, Diarrhea
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Chabad Synagogue Registration Form