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Shabbat AM 12/3
Please verify reCaptcha before submitting the form.
Please note, services will be at the Potrero Hill Neighborhood House.
Registrant Information
*
First Name
*
Last Name
*
Email for registration confirmation
*
How many people *including yourself* are you registering to attend shabbat services?
Please Select One
1 Person
2 People
3 People
4 People
5 People
If registering more individuals than yourself, be sure to enter each registrants first & last name, and email address.
Person 1: First Name
Person 1: Last Name
Person 1: Email
I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify
*
Please upload your proof of COVID-19 Vaccine
Person 2: First Name
Person 2: Last Name
Person 2: Email
I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify
*
Please upload your proof of COVID-19 Vaccine
Person 3: First Name
Person 3: Last Name
Person 3: Email
I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify
*
Please upload your proof of COVID-19 Vaccine
Person 4: First Name
Person 4: Last Name
Person 4: Email
I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify
*
Please upload your proof of COVID-19 Vaccine
Person 5: First Name
Person 5: Last Name
Person 5: Email
I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify
*
Please upload your proof of COVID-19 Vaccine
If you would like to make a gift to The Kitchen in honor of a simcha or in memory of a loved one, you may do so in the space below
Optional: Indicate a dedication for the donation above
Thu, September 19 2024
16 Elul 5784
Thu, September 19 2024 16 Elul 5784
