In-Person Service Request - Temple Rodeph Torah | Reform Temple

Please complete the form below to pre-register for attendance at the Friday, May 21^st, 7:30 p.m. service.

Social distancing will be observed and masks must be worn. All attendees (maximum of 30) must be fully vaccinated.

This form should be completed by 10:00 a.m. on Wednesday, May 19^th. You will be notified on Thursday, by email and phone, if your name has been chosen.

Name - Attendee #1*
First Last
Email*
Phone*
Name - Attendee #2
Leave blank if this request is only for one person
First Last
Name - Attendee #3
Leave blank if this request is only for two people
First Last
Name - Attendee #4
Leave blank if only this request is only for three people
First Last
Vaccination Confirmation*
- All attendees are fully vaccinated
Proof of Vaccination Will Be Required*
- I understand that all attendees will be required to show their vaccination cards or photo thereof
Risk Statement Confirmation*
In the interest of complete transparency, Temple Rodeph Torah wishes to reinforce to attendees that visiting our building carries an inherent risk of being exposed to or contracting the coronavirus or COVID-19. By coming, you indicate your acknowledgment, acceptance, and assumption of these risks.
- Risk statement has been read and understood
Additional Info (if needed)