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Shabbat Attendance Questionnaire

Thank you for your interest in attending Shabbat morning services at Temple Beth Am in person. Please have each member of your family who is planning to attend fill out this form.

We will contact you to confirm your attendance.

The following question is optional and this information is being collected to enhance our continuing efforts to reopen the Temple:

We will notify you whether you have been selected to attend the Shabbat service you have chosen. If you are, we will follow up with a health questionnaire which must be submitted no later than 10:00AM on the Friday prior to the Shabbat you selected. We will also provide information as to the procedures we will be following during services on Shabbat.

By checking the "I agree to the release and waiver of liability" checkbox, you understand there is an inherent risk to attending services at Temple Beth Am during this time. You voluntarily enter into this release and waiver of liability, and hereby release any and all rights, claims and causes of action relating to attendance or participation in services, and hereby discharge Temple Beth Am, Margate FL, its’ officers, directors, employees and volunteers, from any liability for any injury or illness that may occur, including but not limited to the contraction of the COVID-19 virus.

Sat, June 12 2021 2 Tammuz 5781