Youth Groups & Holiday Program Sign Up Form - Form - West Side Institutional Synagogue

At West Side Institutional Synagogue, we are excited to return to fun at shul, strictly following COVID-19 guidelines. All shabbat morning groups will begin at 9:50am and end at the same time as the main shul. There will be free play for early arrivals at 9:30am. Feel free to reach out to Zach Herskowitz at 516-993-8381 with any questions you may have.

For health purposes, please fill out the form below to sign your child(ren) up for our youth programming before they attend. Your registration is critical to our preparation.

PARENT/GUARDIAN INFORMATION

* First Name

* Last Name

* Phone

* Email

* Relationship

Other Guardian First Name

Other Guardian Last Name

Other Phone

Other Email

Other Relationship

Home Address

* Are you a member of WSIS or WSSS?

WSISWSSSN/A

CHILD-1 INFORMATION

Child-1 First Name

Child-1 Last Name

Gender

Grade

School

Date of Birth

Child-1 Phone

Child-1 Email

PLEASE SELECT ALL PROGRAMS THIS CHILD WILL ATTEND

CHILD-2 INFORMATION

Child-2 First Name

Child-2 Last Name

Gender

Grade

School

Date of Birth

Child-2 Phone

Child-2 Email

PLEASE SELECT ALL PROGRAMS THIS CHILD WILL ATTEND

CHILD-3 INFORMATION

Child-3 First Name

Child-3 Last Name

Gender

Grade

School

Date of Birth

Child-3 Phone

Child-3 Email

PLEASE SELECT ALL PROGRAMS THIS CHILD WILL ATTEND

CHILD-4 INFORMATION

Child-4 First Name

Child-4 Last Name

Gender

Grade

School

Date of Birth

Child-4 Phone

Child-4 Email

PLEASE SELECT ALL PROGRAMS THIS CHILD WILL ATTEND

COMMITMENT TO COMBAT COVID-19

* Check here to indicate that you and your family agree to adhere to the WSIS Kidzone COVID-19 Guidelines

Check here to indicate that you and your family agree to adhere to the WSIS Kidzone COVID-19 GuidelinesChecking the box above indicates that you will instruct your children to do the following:

WEAR A MASK AT ALL TIMES
STAY IN DESIGNATED GROUP LOCATION
DO NOT BRING ANY FOOD OR DRINK FROM HOME
SANITIZE HANDS WHEN INSTRUCTED
STAY HOME IF SICK OR LEGALLY MANDATED TO QUARANTINE DUE TO EXPOSURE OR TRAVEL