Adat Ari El Covid Health Screening Form

* First Name

* Last Name

* Email Address

* Mobile Number

* Reason visiting campus

* Do you live in the same household with, or have you had close contact with someone who in the past 14 days was diagnosed with COVID-19 or had a test confirming they have the virus?

* Within the last 10 days have you been diagnosed with COVID-19 or had a test confirming you have the virus?

* Have you had any one or more of these symptoms today or within the past 24 hours, which is new or not explained by a pre-existing condition?Fever, Chills, or Repeated Shaking/Shivering • Cough • Sore Throat • Shortness of Breath or Difficulty Breathing • Feeling Unusually Weak or Fatigued • Loss of Taste or Smell • MusclePain • Headache • Runny or Congested Nose • Diarrhea

* Have you traveled within the past 14 days?

If yes, where?

* By checking 'Yes' below I attest that my answers above are accurate to the best of my knowledge.

Yes

* By checking 'Yes' below I affirm I will notify Adat Ari El if there are any changes to my answers that occur after I complete this form, and before I arrive to the Adat Ari El campus. I will reschedule and not come to campus if there are any changes.

Yes

* On behalf of yourself and/or your children, you hereby release, covenant not to sue, discharge, and hold harmless Adat Ari El its employees, agents, and representatives, of and from all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating to your participation in our programs, services, or activities. You understand and agree that this release includes any claims based on the actions, omissions, or negligence of this organization, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any hosted or programmed event by this organization.

On behalf of yourself and/or your children, you hereby release, covenant not to sue, discharge, and hold harmless Adat Ari El its employees, agents, and representatives, of and from all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating to your participation in our programs, services, or activities. You understand and agree that this release includes any claims based on the actions, omissions, or negligence of this organization, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any hosted or programmed event by this organization.

Sat, July 12 2025
16 Tammuz 5785

Upcoming Events

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Saturday ,
JulJuly 12 , 2025

Tot Shabbat
Shabbat, Jul 12th 10:00a

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Friday ,
AugAugust 15 , 2025

ECC Closed
Friday, Aug 15th (All day)

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Friday ,
AugAugust 15 , 2025

N'ranena Kabbalat Shabbat Services
Friday, Aug 15th 6:00p

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Saturday ,
AugAugust 16 , 2025

Beit Midrash - Drash FY 25-26 Cohort 2
Shabbat, Aug 16th 12:30p

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Saturday ,
AugAugust 16 , 2025

Tot Seudat Shlishi
Shabbat, Aug 16th 4:30p

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Monday ,
AugAugust 18 , 2025

ECC Closed | Staff Development
Monday, Aug 18th (All day)

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Sunday ,
AugAugust 24 , 2025

Bar Mitzvah | Dylan Borenstein
Sunday, Aug 24th (All day)

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Sunday ,
AugAugust 24 , 2025

AAE Board Orientation
Sunday, Aug 24th (All day)

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Sunday ,
AugAugust 24 , 2025

ECC Welcome BBQ
Sunday, Aug 24th 4:00p to 6:00p

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Monday ,
AugAugust 25 , 2025

ECC Nest Open | ECC Preschool Closed | ECC Staff Development
Monday, Aug 25th (All day)

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Sat, July 12 2025 16 Tammuz 5785

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Contact Us

12020 Burbank Blvd.
Valley Village, CA 91607

Main Number: 818.766.9426

| Staff Directory
| Email Us!
| Directions

Upcoming Events

All Events

Saturday ,
JulJuly 12 , 2025

Tot Shabbat
Shabbat, Jul 12th 10:00a

MORE INFO
Friday ,
AugAugust 15 , 2025

ECC Closed
Friday, Aug 15th (All day)

MORE INFO
Friday ,
AugAugust 15 , 2025

N'ranena Kabbalat Shabbat Services
Friday, Aug 15th 6:00p

MORE INFO

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12020 Burbank Blvd.
Valley Village, CA 91607

Main Number: 818.766.9426

| Staff Directory
| Email Us!
| Directions

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12020 Burbank Blvd.
Valley Village, CA 91607
818.766.4992
shalom@aaeds.org

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Through Jewish vision and values, Adat Ari El Labowe Family Day School raises up students who KNOW themselves, SERVE others, and ACT to improve the world.

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12020 Burbank Blvd.
Valley Village, CA 91607
818.766.9426
info@adatariel.org

(818) 766-9426

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