Shani Reiss Bat Mitzvah Registration Please complete this form to register for Shabbat at Great Neck Synagogue. Shani Reiss Bat Mitzvah Please complete the below form to pre-register to attend minyanim at the Great Neck Synagogue. Name* First Last Email* Cell phone*Are you a member of Great Neck Synagogue?*YesNoPlease confirm your agreement to the below by checking the appropriate boxI will not attend Great Neck Synagogue for any purpose if: (i) I have had direct contact with a COVID-19 positive patient, defined as being within 6 feet for greater than 15 minutes. If so, I understand that I need to stay at home for 14 days and self-monitor for symptoms, OR (ii) I have been diagnosed with a current case of COVID-19 or exhibit any symptoms of COVID-19. If so, I understand that I need to stay at home until: a) 10 days have passed from symptom onset; and b) 3 days have passed without symptoms when off medications. Agree I will not attend Great Neck Synagogue if I or a member of my household has recently travelled to any region experiencing an outbreak of COVID-19, and I agree to: (i) not attend for 14 days if I have travelled to any of the states designated by New York State as having experiencing outbreaks; (ii) not attend for 14 days after any international travel (including from Israel); and (iii) comply with any applicable federal or state rules about self-quarantine that may be issued or amended in the future. Agree I agree to comply with Great Neck Synagogue’s safety policies and protocols, including wearing a face covering at all times on Great Neck Synagogue premises and following Great Neck Synagogue’s social distancing requirements Agree I understand that COVID-19 is contagious and poses serious health risks. I am voluntarily assuming the risks of choosing to attend services at Great Neck Synagogue. I agree that I will not assert any claim against Great Neck Synagogue, its officers, trustees or employees (together, “GNS”) related to attending services or other events at Great Neck Synagogue. I expressly disclaim GNS of all liability for any claims related to COVID-19, including, but not limited to claims based in tort or contract, and claims based on any alleged negligent act or omission by GNS, including for matters known or unknown to GNS Agree Δ