Yom Kippur Confirmation Form 5783 / 2022

In order to plan accordingly, please indicate on the registration form 1) how you plan to participate (either in person, online or a combination) and 2) if in-person, how many are planning to attend each service.

Please note: Masks are required for all services and study, and everyone above the age of two is required to be masked inside the building. Everyone above the age of five is required to be up to date with their COVID vaccinations including their most recent booster shot, if eligible; children from 6 months to four are expected to have begun receiving their vaccinations. You can find current COVID protocols on our website. Should conditions change, we will communicate this to the congregation.

Name badge inserts (tickets) and the links for the services are available for all members in good standing. Beth Emet's policy defines any member who pays at least 25% of their total current membership commitment and paid all outstanding prior balances or has made payment arrangements. Should this present an issue, please contact Bekki Kaplan at kaplan@bethemet.org or call 847-869-4230. No member will ever be denied as long as payment arrangements have been made prior to Yom Kippur.

If you require assistance in filling out the form, please contact the office at office@bethemet.org or call 847-869-4230 x 0. We have enlisted a team of volunteers to respond and help guide you through the process.

HIDDEN - Date Entered into SalesForce:

YOUR NAME

Only one registration needed per household.

First Name

Last Name

Beth Emet Member

YesNo

CONTACT INFORMATION

Address

City

State

Zip code

Home Phone

Mobile/Alternate Phone

Preferred Email

What interests you about Beth Emet?

How are you connected to Beth Emet

EMAIL INFORMATION CONFIRMATION

To ensure that we are sending the information to access services and important holiday-related details to the correct address, please confirm the email address(es) for your household.

Preferred Email

Do you wish to add additional email addresses for your member household?

Additional Email Address

Name

SERVICE REGISTRATION

Each service will be offered both in-person as well as online. For a complete listing of services please check our website.

We require everyone five and older to be up-to-date with their vaccinations, including the most recent available booster, and have signed the brit (Covenant of Responsibility). For those under 5 attending youth services, vaccinations are strongly recommended as they will be required at some point in the Fall.

I/We Plan to Attend Services (please choose one of the following):

In-Person Participation

Please let us know which service you plan to attend so that we can plan accordingly (especially for Kol Nidre). Please note that all services will also be livestreamed.

Name(s) of Those Attending Including Yourself

First Name

Last Name

Last Booster/Shot

Everyone above the age of five is required to be up to date with their COVID vaccinations including their most recent booster shot, if eligible; children from 6 months to four are expected to have begun receiving their vaccinations.

Yom Kippur

Please indicate the services and/or study this person plans on attending:

	Attending
Kol Nidre - Tues. Oct. 4 at 7:00 p.m.
Chavurah Service - Wed., Oct. 5 at 9:00 a.m.
Adult Study - Wed., Oct. 5 at 9:30 a.m.
Traditional Service - Wed., Oct. 5 at 11:30 a.m.
Adult Study - Wed., Oct. 5 at 2:00 p.m.
Family Service for Grades 2-4 - Wed., Oct 5 at 2:00 p.m.
Concluding Services - Wed., Oct. 5 at 4:00 p.m.

To add additional names click the "Add Another Name" below.

For Worshippers with Special Needs

Do you have worshippers that have special needs?

Please indicate how many accessible seats you will need on Yom Kippur:

I will need a parking space on:

Kol Nidre Service - Tues., Oct. 4 at 7:00 p.m.Yom Kippur Chavurah Service - Wed., Oct. 5 at 9:00 a.m.Yom Kippur Adult Study - Wed., Oct. 5 at 9:30 a.m.Yom Kippur Traditional Service - Wed., Oct. 5 at 11:30 a.m.Yom Kippur Adult Study - Wed., Oct. 5 at 2:00 p.m.Yom Kippur Concluding Services - Wed., Oct. 5 at 4:00 p.m.

Are there special needs requests or considerations that would make your worship more meaningful (e.g. seating location, attendance with a caregiver)?

Additional Links

If you wish to request virtual access for non-member friends or family, please indicate below. While there is no charge, please consider a donation in whatever amount feels appropriate in lieu of the standard guest charge. (See sponsorship opportunities below.)

First and Last Name

Relationship

Email Address

Brit / Covenant of Mutual Responsibility

UPDATED AS OF 7/20/22 Our tradition teaches us that we are all responsible for each other and that protecting life is a value of paramount importance. Since the beginning of the pandemic we have upheld these values by maintaining distance, when appropriate, wearing masks at all times when in the building (other than for a brief period while eating or drinking, when permitted) and following other protocols to keep ourselves and others safe from the COVID-19 virus. While COVID continues to be prevalent in our greater community, we require that all who are eligible be vaccinated including the most recent booster available allowed by the CDC. We acknowledge that those who are ages 5 to 6 months-old only recently became eligible, and understand that this cannot yet be a requirement. We also strongly encourage everyone to get their boosters. In order to come together safely, and to protect those who are not yet vaccinated, those who are vaccinated but the efficacy is waning and/or those who may not be able to get vaccinated, we all need to take responsibility for adhering to the following protocols: Before coming to Beth Emet for any event, we ask that you acknowledge the following Covenant of Mutual Responsibility. By submitting this form, I/We agree to follow the prevailing safety protocols when at Beth Emet. As of today, these include:

Wearing a multi-layer mask properly covering mouth and nose in the building as communicated by staff.
Keeping appropriate distance between myself and others, as communicated by staff.
Staying home if I am sick or have symptoms that might mean I am sick.
Complying in a responsible and respectful manner with instructions from staff and volunteers who have been designated to implement the health, safety, and security practices.

While Beth Emet strives to maintain a clean and healthy environment, Beth Emet is not responsible for injuries or sickness that may result from the pandemic, and by entering Beth Emet property, I/we am voluntarily assuming this risk.

I/We have read the Covenant of Mutual Responsibility on behalf of my/our household:

COMMUNITY VOLUNTEER OPPORTUNITIES

There are many new opportunities to get involved and/or to let us know if we can be of assistance.

Ushering

	Yes
Would you be interested in ushering for services?

Name(s) of those who are interested

Which service(s)?

	Yes
TORAH & HAFTARAH CHANTING: Can you chant Torah and/or Haftarah or are interested in learning?

Name(s)

	Yes
TECH ASSISTANCE: Do you need tech help to ensure you have access to the virtual services?
TECH ASSISTANCE: If you have tech skills and are interested in helping those who may need assistance, please let us know.

Name(s)

FOOD DRIVE: Would you like to volunteer to help with the Food Drive collection in the parking lot on Yom Kippur (October 5) or Sunday, October 9 from 9:30 am - 1:00 pm?

Name(s)

MEDICAL HEALTH CARE PROFESSIONAL ON CALL: It is always reassuring to know that we have a designated medical professional at each service should the need arise. If you are a medical health care professional and are interested, please let us know.

Name(s)

SPONSORSHIP OPPORTUNITIES

Each year we rely on the generosity of our members to support our High Holy Day worship services and programs. This year our goal is to raise $50,000 which will allow us to continue to make services accessible by offering the technology that supports the fusion model of worship and study as well as support other costs to ensure that our holiday participation is as meaningful and beautiful as in years past. And while non-member tickets were a significant source of revenue pre-pandemic, we extend the opportunity for guests to access the High Holy Days again this year without a charge. We can make this possible through your generous support which allows us to open and expand our home to those who wish to be a part of our community.

Sponsorship Opportunities:

I / We will contribute:

Other amount

Tribute options:

List "other"

Name(s) that you are honoring

Do you wish to send an acknowledgement to the recipient?

Address of recipient who will receive acknowledgement

List how you wish to be acknowledged publicly or whether you wish to donate anonymously:

SPONSORSHIP OPPORTUNITIES

While we do not charge $250 per ticket for non-members as we did pre-pandemic, we do incur a significant cost to provide services and programs to all. This year, more than ever, we are counting on your support. Thank you!

I / We will contribute:

Other Amount

List how you wish to be acknowledged publicly or whether you wish to donate anonymously:

YIZKOR (Memorial) BOOK

The coming High Holy Day season brings with it memories of families and friends praying together, past joys, and the sadness of recalling those loved ones who are no longer with us. You have the opportunity to memorialize your loved ones and honor their memory by inscribing their names in Beth Emet's Yizkor (Memorial) Book. Given printing deadlines, entries cannot be accepted after Monday, August 29.

Do you wish to renew or update listing from prior years or is this a new submission?

Listing

Remembered by:

Name to be remembered:

Would you like this/these name(s) added to your yahrzeit record?

Add the name and date of death

Relationship

Other

In loving memory, I / We will contribute:

Other amount:

MACHZOR (Prayerbook)

During the High Holy Days (except the Chavurah and family services) we use the machzor (prayerbook), Mishkan HaNefesh. If you need a new or additional machzor(s), each set is $65 (if you wish to have them mailed) or $60 if you wish to pick them up at the office.

Machzor sets at $65 (mail) or $60 (pick up)?

MACHZOR (Prayerbook)

Machzor sets at $65 (mail) or $60 (pick up)?

DISTRIBUTION OF MATERIALS

This year we encourage you to come to Beth Emet to pick up your materials including name badges, your High Holy Day Guide and Yizkor (Memorial) Book. The office will be open the week of September 12 (Monday thru Thursday between 9:00 am to 5:00 pm, Friday 9:00 am until 3:30 pm and Thursday evening, September 15 from 5:00 to 9:00 pm To help us plan accordingly, please let us know.

How do you wish to receive the High Holy Day materials?

SUKKOT (Starts October 9)

Lulav & Etrog Sets: I/We would like to order a Lulav and Etrog set for Sukkot ($50 per set), and will pick-up at Beth Emet. Watch EmetMail for more information on Sukkot and Simchat Torah. Please indicate the number of sets to order:

BABYSITTING

Babysitting is $10 per child, per service. All children age 5 and above are required to be vaccinated. All children age 2 and above are required to wear a properly fitting mask. Advance registration is required.

Do you have children that require babysitting?

First Name

Last Name

Age

Yom Kippur Chavurah Service - Wed., Oct. 5 at 9:00 a.m.

Yom Kippur Traditional Service - Wed., Oct. 5 at 11:30 a.m.

Yom Kippur Concluding Services - Wed., Oct. 5 at 4:00 p.m.

Total babysitting charge $:

Please note any specific childcare requests/ information (please include the name of the child).

PAYMENT

Grand Total $

How do you wish to pay

Additional questions or comments?

PAYMENT

Total Amount Due

Minimum Amount Due

Remaining

Would you like to pay later and have us bill your account?

YesNoThis option is for current members only

Payment Method

*Transaction Fees:

Credit card transactions will be assessed a 3% fee.
$0 transaction fee when sending in a check (option for current members in Good Standing only) or Automatic Debit from Checking Accounts.

Payment Options

Pay in FullSetup Monthly Payment Plan

Note: All balances need to be paid in full by April 30, 2023.

If you wish to pay throughout the year (rather than on a pre-established schedule), please select "pay monthly" and then indicate you are paying by check.
If you wish to accelerate payments please update the number of months directly below.

Pay Balance Over

Months

Due Now

Transaction fee for amount due now

Total Due Now

Monthly Amount Due

Transaction fee for each monthly payment

Total Monthly Amount

Amount for Each Check Due

Total Payments

Payment Information

Name on Card

Card Number

Code

Payment Information

Name on Account

Bank Name

Bank Routing Number

Bank Account Number

Account Type

CheckingSavings

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Billing AddressOther Billing Address

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Billing Address

First Name

Last Name

Address

City

State

Postal Code

Billing Email

Billing Address

First Name

Last Name

Address

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Additional questions or comments?

Kol Nidre at 7:00 pm	Yom Kippur Chavurah
Yom Kippur Traditional Morning Service	Yom Kippur Grades 2 - 4
Yom Kippur Afternoon