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Home
Kristallnacht Commemoration 11/9/25
Please verify reCaptcha before submitting the form.
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First Name
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Last Name
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Email Address
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Phone Number
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Are you a member of MJC?
Yes
No
Are you a member of another synagogue?
Yes
No
What other synagogue do you belong to?
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Number of Adults
0
1
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5
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9
10
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Please list the names of adults attending
Number of Children (9 years and older)
0
1
2
3
4
5
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8
9
10
Please list names and ages of children attending
*
By checking here, I agree to abide by all security measures put in place by MJC for the day of this program.
By checking here, I agree to abide by all security measures put in place by MJC for the day of this program.
*
I understand that photos and/or videos may be taken by MJC at this event that may be used for promotional purposes in emails, on social media, and in print. I hereby grant permission for such use, and I hereby release the Merrick Jewish Centre, and its officers and directors, from any claims and liability that may arise from use of said photographs and/or videos. If I decide to not allow photos or videos of me or my child(ren) to be used I understand that I need to contact MJC at comms@mjc.org within 24 hours of the event ending.
I understand that photos and/or videos may be taken by MJC at this event that may be used for promotional purposes in emails, on social media, and in print. I hereby grant permission for such use, and I hereby release the Merrick Jewish Centre, and its officers and directors, from any claims and liability that may arise from use of said photographs and/or videos. If I decide to not allow photos or videos of me or my child(ren) to be used I understand that I need to contact MJC at comms@mjc.org within 24 hours of the event ending.
Wed, November 5 2025 14 Cheshvan 5786
