Mikveh As A Spiritual Practice
Wednesday, September 11, 18, 25 & Sunday, September 29

As we prepare for the High Holidays, we enter the sacred month of Elul, a time of deep spiritual preparation and self-reflection. Mikveh (the ritual of immersion in living water) offers us a special opportunity to reflect on who we are, who we want to be, and what we want to leave behind in the water as we enter the new year. This special multi-part workshop, a unique collaboration between Mayyim Hayyim and The Well at Temple Beth Elohim, will help participants explore the ancient ritual of mikveh and its potential for personal transformation and meaning in their own lives.

REGISTRATION

Are you a TBE Member?

YesNo

Number of adults attending:

Number of adult members attending:

Number of adult non-members attending:

First Name

Last Name

Mobile Phone

Primary Email

First Name

Last Name

Mobile Phone

Primary Email

First Name

Last Name

Mobile Phone

Primary Email

First Name

Last Name

Mobile Phone

Primary Email

CUSTOM QUESTIONS

Are you age 65 or older?

Yes

How will you be attending?

In PersonOnline

Will you be taking the bus?

Yes

I would be interested in carpooling with TBE

Yes

SESSION DATES

Please let us know which sessions you will be attending::

Wednesday, September 11 - 6:00-7:30 PM: Mikveh 101 and Mayyim Hayyim TourWednesday, September 11 - 7:30-8:00 PM: Vegetarian Dinner at Mayyim HayyimWednesday, September 11 - 8:00-9:00 PM: Mikveh 201: Mikveh At the High HolidaysWednesday, September 18 - 7:00-8:30 PM: Why Are Personal Jewish Rituals Important in a Modern World?Wednesday, September 25 - 7:00-8:30 PM: Creating Your Own Water or Immersion RitualSunday, September 29 - TBE at Mayyim Hayyim Immersion Open House Day

NUMBER OF CHILDREN ATTENDING

Number of youth members attending:

Number of youth non-members attending:

Number of children attending:

First Name (Child #1)

Last Name (Child #1)

Grade (Child #1)

Age (Child #1)

First Name (Child #2)

Last Name (Child #2)

Grade (Child #2)

Age (Child #2)

First Name (Child #3)

Last Name (Child #3)

Grade (Child #3)

Age (Child #3)

First Name (Child #4)

Last Name (Child #4)

Grade (Child #4)

Age (Child #4)

First Name (Child #5)

Last Name (Child #5)

Grade (Child #5)

Age (Child #5)

First Name (Child #6)

Last Name (Child #6)

Grade (Child #6)

Age (Child #6)

First Name (Child #7)

Last Name (Child #7)

Grade (Child #7)

Age (Child #7)

First Name (Child #8)

Last Name (Child #8)

Grade (Child #8)

Age (Child #8)

First Name (Child #9)

Last Name (Child #9)

Grade (Child #9)

Age (Child #9)

SESSION CHOICES

Members

FallWinter Spring ISpring II

Non Members

FallWinter Spring ISpring II

PHOTO & VIDEO PERMISSIONS

I grant my permission to use any and all written comments, pictures, or video in which my child or I may appear for print, audio, visual, and/or electronic publicity promotion and advertising on behalf of TBE and its programs.

YesNo

DIETARY RESTRICTIONS & FOOD ALLERGIES

Please list any dietary restrictions and/or food allergies:

GENERAL & MEDICATION ALLERGIES

Please list any general allergies and/or allergies to medications:

MEDICAL CONDITIONS

Please list any medical conditions:

EMERGENCY CONTACT INFORMATION

Emergency Contact #1

Full Name

Mobile Phone

Primary Email

Relationship

Emergency Contact #2

Full Name

Mobile Phone

Primary Email

Relationship

BILLING INFORMATION

First Name

Last Name

Primary Email*

Mobile Phone

Billing Street

Billing Unit/Apt.

Billing City

Billing State

Billing Zip Code

Is your mailing address the same as your billing address?

YesNo

Mailing Street

Mailing Unit/Apt.

Mailing City

Mailing State

Mailing Zip Code

Credit Card No.

Exp. Month

MM

Exp. Year

YYYY

Verification Code

Total

$

HIDDEN FIELDS

Form Requests Hidden Fields

FORM #1: ARE YOU A TBE MEMBER?

Yes

FORM #2: # OF ADULTS ATTENDING?

Yes

FORM #3: # OF ADULT MEMBERS ATTENDING?

Yes

FORM #5: # OF ADULT NON-MEMBERS ATTENDING?

Yes

FORM #6: ARE YOU 65 OR OVER?

Yes

FORM #7: HOW WILL YOU BE ATTENDING?

Yes

FORM #8: WILL YOU BE TAKING THE BUS?

Yes

FORM #9: I WOULD BE INTERESTED IN CARPOOLING

Yes

FORM #10: TOT SHABBAT DINNERS & Multiple Series Sign up Checkboxes

Yes

FORM #11: # OF CHILDREN ATTENDING?

Yes

FORM #12: # OF YOUTH MEMBERS ATTENDING?

Yes

FORM #13: # OF YOUTH NON-MEMBERS ATTENDING?

Yes

FORM #14: SESSION SEASONAL BOXES FOR MEMBERS & NON-MEMBERS?

Yes

FORM #15: PHOTO & VIDEO PERMISSIONS?

Yes

FORM #16: DIETARY RESTRICTIONS & FOOD ALLERGIES

Yes

FORM #17: MEDICAL CONDITIONS

Yes

FORM #18: GENERAL/MEDICATION ALLERGIES

Yes

FORM #19: SUGGESTED DONATION

Yes

FORM #20: EMERGENCY CONTACT (NAME, PHONE NUMBER, EMAIL, RELATIONSHIP

Yes

General Hidden Fields

Authnet_Hidden_Fields

reCAPTCHA helps prevent automated form spam.

The submit button will be disabled until you complete the CAPTCHA.