2017/5778 High Holy Days Pass Request Form

This High Holy Days Pass Request form is for Am Shalom members. If you are not a member but would like to participate in High Holy Days worship at Am Shalom, please contact Alyssa Latala at alatala@amshalom.com or 847.835.4800.
High Holy Days Dates:
EREV ROSH HASHANAH: WEDNESDAY, SEPTEMBER 20, 2017
ROSH HASHANAH: THURSDAY, SEPTEMBER 21, 2017
SECOND DAY ROSH HASHANAH: FRIDAY, SEPTEMBER 22, 2017
EREV YOM KIPPUR: FRIDAY, SEPTEMBER 29, 2017
YOM KIPPUR: SATURDAY, SEPTEMBER 30, 2017
Once again we are utilizing a "Universal Pass." The pass will list all service times for the High Holy Days - you will not be asked to select early or late services. Everyone can use their "Universal Pass" to attend the services that best fit their schedules.
Family and Tot Services will be held on Thursday, September 21 AND Saturday, September 30. Tot Services are at 9:00 a.m. and Family Services are at 2:00 p.m.
Do you need Tot/Family Passes Only?(*)
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Please select "yes" if you do NOT need a Universal Pass (you will only be attending the Tot and/or Family Services). Family and Tot Services are included with the passes for Congregational Services.

Family Name(*)
Please let us know your name.

Primary Email(*)
Please let us know your email address.

Street Address(*)
Please write a subject for your message.

City(*)
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State(*)
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Zip Code(*)
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Primary Phone Number(*)
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List the names of people who will be using the passes - including yourself and your immediate family
*College students only need a current school I.D. - do not list their names*
Member 1(*)
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Member 2
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Child 1
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Child 1 Age
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Do you need babysitting for this child?
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Child 2
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Child 2 Age
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Do you need babysitting for this child?
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Child 3
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Child 3 Age
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Do you need babysitting for this child?
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Child 4
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Child 4 Age
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Do you need babysitting for this child?
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Your Universal Pass will be accepted at any and all services. For our planning purposes, please check the services you plan to attend. (*)

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Do you have any special needs requests for any member of your party?
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Request Family or Tot Service here ONLY if you are not requesting passes for any of the above Services.

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Passes are required for each family member (except for college students with ID) for admittance to ALL services. Only parents require passes for Tot and Family Services.
Request additional passes for children 25 years and older and extended family at $200 per pass:
How many additional passes do you need?(*)
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Additional Pass 1(*)
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Relationship to family(*)
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Additional Pass 2(*)
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Relationship to family(*)
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Additional Pass 3(*)
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Relationship to family(*)
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Additional Pass 4(*)
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Relationship to family(*)
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Additional Pass 5(*)
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Relationship to family(*)
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Additional Pass 6(*)
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Relationship to family(*)
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Amount Owed for Additional Passes
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Do you have any additional comments, questions, or concerns?
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Name
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Please note: Special needs parking will be available in existing designated parking spots.
Please check the appropriate boxes for your special needs requests

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Please check every Service you will attend for which you will have a wheelchair request:

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*If you have any other special need requirement(s) please contact Director of Member Services Leslie Nathan; she will be happy to assist you.