Teen Tefillah

* Please confirm that you are in good health and will let us know if something changes:

NoYes1) At this time and to the best of my knowledge, no one in our family has been exposed to someone with a positive lab test for Covid-19 in the past 14 days.

2) No one in our family currently has a fever over 100 degrees or unexplained symptoms such as loss of taste or smell, difficulty breathing, coughing, headaches or gastrointestinal difficulties.

3) If any of us develop symptoms or find out we have been exposed to someone with Covid-19 I will let the Bayit office know as soon as possible and will not attend programs at the Bayit.

Do you agree to wear a face mask at all times while you are at tefillah and sanitize your hands or when you arrive?

NoYes

I understand that attending any prayer service, class or other program at the Bayit is my choice. I therefore release Hebrew Institute of University Heights, dba Hebrew Institute of Riverdale from any and all liability for any unintentional exposure to viral or bacterial infection.

First Name

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Last Name

* Cell Phone Number

By filling out this form you agree to provide your cell phone number and join the WhatsApp group "Bayit Shabbat Tefillah".

* Email Address

Name(s) of Teens and Grade(s)

Attending Teen Tefillah (check all that apply)

Bo - January 23Beshalach - January 30Yitro - February 6Mishpatim - February 13Teens must complete a health assessment each week to attend Tefillah. Signing up for multiple weeks will help us remind you each Friday to complete the assesment.

Please indicate if you are willing to (check all that apply):

Lead ServicesLeynGive a Devar Torah

Please consider sponsoring this weeks Teen Kiddush

Please choose one$36$54$108

Sponsorship Dedication:

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