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	Information Required to Attend in-person Shabbat services at Beth Tikvah. * Name of Person Attending If more than 1 person from your family has been selected to attend services, please fill out a separate form. Thank you. Please fill out the Ontario Covid-19 self-assessment tool by CLICKING HERE   * I confirm all of the following statements by checking off all of the 3 boxes: I confirm that I have completed the Ontario COVID-19 self-assessment ToolI confirm that I am not currently experiencing any of the symptoms listed in the Ontario Covid-19 self-assessment toolI confirm that I am not in any of the at-risk groups listed in the Ontario Covid-19 self-assessment tool * By checking these boxes you agree to all of the following statements. Please read carefully. Notice to all attendees and users to Beth Tikvah Synagogue: I acknowledge and understand that the novel coronavirus causes the disease known as COVID-19I acknowledge and understand that the novel coronavirus has a long incubation period, where carriers of the virus may not show symptoms and still be contagiousI acknowledge and understand that there is a possibility, although very small, that I could be at risk of exposure to COVID-19 by attending Beth TIkvah Synagogue and by using its facilityI acknowledge and agree that I will wear a mask inside the building and remain socially distant.
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