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Shabbat AM 10/15
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Registrant Information
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First Name
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Last Name
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Email for registration confirmation
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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
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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
Sun, September 22 2024
19 Elul 5784
Sun, September 22 2024 19 Elul 5784
