Abridged Family Megillah Reading 2022 - Form

Wednesday, March 16 at 5:00 p.m.

Come together either in-person or online (in your best costume, of course) for an early and abridged Megillah reading. Perfect for little ones and older ones too. We'll retell the Purim story, listen to parts of Megillat Esther, and make lots and lots of noise!

* First Name

* Last Name

* Email

* Phone

* I/we would like to join this "Abridged Family Megillah Reading"

Please Select OneIn-PersonOnline

Excellent! We will email you with information on accessing our virtual livestream soon.

DISCLAIMER - EXCLUSION OF LIABILITY

Notice to all Attendees and Users of Beth Tzedec Congregation Prayer Services and Facilities

As a condition of attending and using the facilities of Beth Tzedec Congregation ("Beth Tzedec"), I assume all health risks relating to contracting COVID-19 while using the facilities of Beth Tzedec and agree that Beth Tzedec and its directors, officers, employees, agents, volunteers, sponsors and representatives shall not be liable for any illness or other consequences that may be attributed to my attendance and use of the facilities of Beth Tzedec and I hereby waive all claims against Beth Tzedec and its directors, officers, employees, agents, volunteers, sponsors and representatives with respect thereto. I further agree that the assumption of risks, agreement and waiver herein shall also apply to any minor person who attends with me and uses the facilities of Beth Tzedec.

* Do you accept all of the above conditions for you and any minor person who attends with you at Beth Tzedec?

Please Select OneYesNo

USE OF INFORMATION

As a condition of Beth Tzedec considering my request to attend and use the facilities of Beth Tzedec, I authorize and consent to Beth Tzedec collecting and maintaining the data or information provided by me to Beth Tzedec and I authorize and consent to Beth Tzedec providing such data or information to a public health authority or to any other person as may be considered by Beth Tzedec to be appropriate in the circumstances and I agree that Beth Tzedec and its directors, officers, employees, agents, volunteers, sponsors and representatives shall not be liable for providing any such information or data and I hereby waive all claims against Beth Tzedec and its directors, officers, employees, agents, volunteers, sponsors and representatives with respect thereto. I further agree that this authorization, consent, agreement and waiver shall apply to any minor person in respect of whom I have provided information or data to Beth Tzedec.

* Do you accept all of the above conditions for you and any minor person wth respect to whom you will be providing data or information to Beth Tzedec?

Please Select OneYesNo

As we continue our reopening process, a limited number of services and programs are open to those who register and commit to complying with the health and safety protocols. To view our COVID protocols, click here>>

* Are you (or any minor person for whom you're completing this form) vaccinated as per the policy above?

Please Select OneYes, and I've already verified my vaccination status with Beth Tzedec.Yes, but I still need to verify my vaccination status.I am not interested in sharing my vaccination status or providing a COVID-19 test.

Excellent! You only need to verify your vaccination status once, so you're good to go.

If you are vaccinated as per Beth Tzedec's vaccination policy, please be sure to verify your vaccination here>> so that we can confirm your registration.

* Do you agree to wear a mask at all times while in the building and on the grounds of Beth Tzedec?

Please Select OneYesNoNo, I have an eligible exemption

* For programs offered for both in-person and virtual participation, please note that all attendees may find themselves in view of the camera. Do you consent to having your image filmed and/or photographed and broadcast and/or recorded to all Beth Tzedec channels?

Please Select OneYesNo

Unfortunately, you are not eligible to attend this program in person. Thank you for your interest. We hope that you decide to join us online!

If you have further questions, please contact Daniel Silverman at dsilverman@beth-tzedec.org

* Are you completing this registration form for a child under the age of 18?

Please Select OneYes, I'm completing this form for someone under 18.No, I'm completing this form for myself.

* Child's Name

* Child's Age

Please enter the name and contact information of the adult who will be accompanying this registrant.

* First Name

* Last Name

* Email

* Phone