Family Havdalah in the Parking Lot - Form

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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

Registration must be submitted no later than 3:00 p.m. on Friday, October 23rd.

There will be no walk-ups permitted.

Who Should and Shouldn't Attend

Adults and children may attend as long as they register in advance and are eligible based on the screening criteria below. Children must be accompanied by a parent or guardian at all times.

Individuals who are over the age of 70, individuals who are immunocompromised or individuals who have a chronic condition that would make them more likely to have complications from COVID-19 may wish to consult their physician before attending.

Safe Physical Distancing

Everyone on the grounds of Beth Tzedec should follow physical dstancing best practices as outlined in Beth Tzedec's Reopening Manual.

All those participating in this experience are required to bring and wear a mask or face covering that covers your nose, mouth and chin, without gapping.

Attendees who do not follow the procedures described above will be asked to leave the premises and may not be permitted to re-enter until further notice.

Do you agree to adhere to the policies listed above?

Please Select OneYesNo

* Have you experienced any flu-like or COVID-19 symptoms (including fever, cough, muscle aches, tiredness, difficulty breathing, sore throat, diarrhea, conjunctivitis or loss of smell or taste) in the last 14 days?

Please Select OneYesNo

* Have you or someone in your household travelled outside of Canada in the last 14 days?

Please Select OneYesNo

Have you been exposed to anyone with COVID-19 in the last 14 days?

Please Selelct OneYesNo

* Do you agree to wear a mask at all times?

Please Select OneYesNoNo, I have an eligible exemption

* As services continue to be broadcast online, 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

* Are you in the first year of mourning or saying Mourner's Kaddish?

Please Select OneYesNoPlease note that preference will be given to those who are availim or who are saying Kaddish.

Unfortunately, you are not eligible to attend an in-person minyan at Beth Tzedec Congregation. Thank you for your interest. Please note that services will continue to be available on Zoom - learn more about them on the Beth Tzedec website.

If you have further questions, please contact Florence Bendelac at 416-781-3514, ext. 213.

How many people will be attending this experience that are within your personal bubble/pod?

Attendees will be grouped only with those in their bubble/pod/family. Individual attendees are welcome and will be assigned as solo participants and seated as such.

How many of these attendees are adults?

How many of these attendees are children?

Adults are responsible for children in their care at all times.

* First Name

* Last Name

* Email

* Phone Number

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If more than 6 attendees are within your family/pod/bubble, please complete this form and then fill out the form again to capture the additional attendees.

If you are completing this form for a child under the age of 18, please indicate who will be accompanying them during the service.