Membership & HHD Registration 5782

WELCOME BACK!
Thank you for being part of the BDJ Family in 5782! We are thrilled to be back in our shul home, and your membership and trustee-level support will provide the resources that we need to not only return but to enhance.

When you complete your form, please note that we are offering Rosh Hashanah and Yom Kippur morning minyanim in BOTH the Main Sanctuary AND in the Beit Midrash. Both minyanim will offer inspiration, music and meaning, with a commitment to maintaining a pace and meter that is maximally conducive to spiritual focus. The Beit Midrash Minyan will begin a little bit earlier, and offer a more intimate setting.

We are grateful for your support of BDJ and look forward to partnering with you in making BDJ better than ever!

Rav Yosef and Rabbanit Alissa

HOUSEHOLD INFORMATION
Attention current members! Log into your accounts before going any further so that your current data can auto-populate this form. Please update or fill in any missing or incorrect information. For questions, please email chevra@bnaidavid.com or call 310-276-9269.

* Adult 1 Title

Adult 2 Title

* Adult 1 First Name

Adult 2 First Name

* Adult 1 Last Name

Adult 2 Last Name

* Adult 1 Gender

Adult 2 Gender

Adult 1 Hebrew First Name

Adult 2 Hebrew First Name

Adult 1 Hebrew Father Name

Adult 2 Hebrew Father Name

Adult 1 Hebrew Mother Name

Adult 2 Hebrew Mother Name

* Adult 1 Email

Adult 2 Email

* Adult 1 Mobile Phone

Adult 2 Mobile Phone

Adult 1 Birthdate

Adult 2 Birthdate

Occupation (NEW)

* Address

* City

* State

* Zip Code

Home Phone

Tribe

Wedding Anniversary

CHILDREN / TEENS

* Do you have a child or children ages birth - 12th grade?

Child 1

Child 1 First Name

Child 1 Last Name

Hebrew Name

Date of Birth

Cell Phone (for Gr. 7+)

Email (for Gr. 7+)

School

Grade / Age

Allergies

Allergy Severity (check all that apply)

Epi Pen?Airborne Allergy?Contact Allergy?

Are your child's vaccinations up to date?

Please Select OneYesNo---If-you-select-this-option-you-must-provide-a-medical-exemption-for-your-child-to-participate

Does your child have any special needs or is there something that would be helpful for us to know?

Please Select OneYesNo

If yes, please elaborate.

Child 2

Child 2 First Name

Child 2 Last Name

Hebrew Name

Date of Birth

Cell Phone (for Gr. 7+)

Email (for Gr. 7+)

School

Grade / Age

Allergies

Allergy Severity (check all that apply)

Epi Pen?Airborne Allergy?Contact Allergy?

Are your child's vaccinations up to date?

Please Select OneYesNo - If you selection this option you must provide a medical exemption in order for your child to attend Rechov Yeladim

Does your child have any special needs or is there something that would be helpful for us to know?

Please Select OneYesNo

If yes, please elaborate.

Child 3

Child 3 First Name

Child 3 Last Name

Hebrew Name

Date of Birth

Cell Phone (for Gr. 7+)

Email (for Gr. 7+)

School

Grade / Age

Allergies

Allergy Severity (check all that apply)

Epi Pen?Airborne Allergy?Contact Allergy?

Are your child's vaccinations up to date?

Please Select OneYesNo - If you selection this option you must provide a medical exemption in order for your child to attend Rechov Yeladim

Does your child have any special needs or is there something that would be helpful for us to know?

Please Select OneYesNo

If yes, please elaborate.

Child 4

Child 4 First Name

Child 4 Last Name

Hebrew Name

Date of Birth

Cell Phone (for Gr. 7+)

Email (for Gr. 7+)

School

Grade / Age

Allergies

Allergy Severity (check all that apply)

Epi Pen?Airborne Allergy?Contact Allergy?

Are your child's vaccinations up to date?

Please Select OneYesNo - If you selection this option you must provide a medical exemption in order for your child to attend Rechov Yeladim

Does your child have any special needs or is there something that would be helpful for us to know?

Please Select OneYesNo

If yes, please elaborate.

MEMBERSHIP

BDJ Membership

--- or ---

Trustee Circle Membership

The membership options above do not work for me (my household) and I instead pledge the following amount towards my membership (input amount):

Trustee Circle Supporters are the cornerstone of giving for B'nai David-Judea. Pledging once at the beginning of the year streamlines your giving and helps BDJ better plan for its expected revenue and cash flow. It's a win-win! Thank you in advance for your support. Questions? Email Adynna at director@bnaidavid.com.

HIGH HOLIDAY REGISTRATION

* Will you be joining us for the High Holidays this year?

Seating - Seating requests are honored on a first come, first served basis. Seating requests cannot be guaranteed. High Holiday seats are NOT included in the Associate or Newlywed membership levels and must be purchased separately.

Tweens and Teens - While there will be special programming for students in grades 6 - 12 during portions of our High Holiday services, our Teens and Tweens will require seats at a discount rate of $100/seat.
Rechov Yeladim Fees - Please sign up your child using the high holiday registration below. Please indicate "no" for the covid vaccine question.
Covid Vaccinations - Teens and Adults attending for the high holidays, please indicate if you have been fully vaccinated for covid.

Outdoor Minyan - Newly added! The minyan that was supposed to meet in the Beit Midrash will now be meeting at the Kellner Backyard.  This minyan will offer full Rosh Hashanah and Yom Kippur services, including the evenings. It will be mask optional for those who are fully vaccinated. Children who are under 12 may attend but must be masked the whole time and stay with a parent. Unvaccinated adults and unvaccinated children 12 and older are not permitted to attend the outdoor minyan. Requests for the outdoor minyan will be taken on a first come, first serve basis; space is limited.

Membership HHD Seats (Free)

Trustee Circle HHD Seats (Free)

Teen HHD Seats ($100)

Extra HHD Seats ($180)

Rechov Yeladim Fee ($100)

	Name	Location	When	* Covid Vaccine?	Age (kids only)	Notes

Despite all the wonderful progress we have made in "returning to normal", we recognize that the past year and a half has no doubt been above and beyond challenging. As a BDJ family, we would love to hear more about how you and your family are doing (the good and the difficult) and invite you to share that here or contact one of us to discuss. Any sensitive information shared will be held in confidence.

PAYMENT

YOU MUST SELECT A PAYMENT OPTION on the next page for your form to be submitted. Any form without a payment selected WILL NOT BE RECEIVED by the office. If you would like to discuss payment assistance options, select the “Check / Pay Later” option – you may then call the office at 310-276-9269 if needed to discuss.

We look forward to a meaningful and joyous year together.

General Donation

Total

Alot Hashachar	4:48am
Earliest Tallit	5:20am
Netz (Sunrise)	6:09am
Latest Shema	9:30am
Zman Tefillah	10:37am
Chatzot (Midday)	12:51pm
Mincha Gedola	1:25pm
Mincha Ketana	4:46pm
Plag HaMincha	6:10pm
Candle Lighting	7:16pm
Shkiah (Sunset)	7:34pm
Tzeit Hakochavim	8:14pm
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