• COVID-19 Daily Health Attestation Form

    Complete your daily Health Attestation screening before coming to the SJCC.

  • All individuals visiting inside the Stroum Jewish Community Center must successfully meet the screening criteria and must submit a new screening each day when visiting the SJCC. 

    THIS FORM MUST BE FILLED OUT FOR EACH VISIT AND ON THE SAME DAY AS YOUR VISIT.

    If you and/or your child(ren) are approved to be at the SJCC after completing this screening, you will recieve an automated email from Stroum Jewish Community Center (noreply@jotform.com) containing your written approval and today's date. You must be willing and able to present the approval email to any SJCC representative upon request. You may show approval on your smartphone or mobile device, or keep a printed copy with you while at the SJCC.

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  • This form is only required for people entering the building. If you are dropping a child off at J Camp, ECS, or another program and will not go inside, you do not need to submit a form for yourself.

  • Self Health Declaration

  • Symptoms include:

    • Fever or chills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea

  • If you have been exposed to someone with a confirmed case of COVID-19 in the past 14 days, but you are vaccinated and have proof of a negative COVID-19 test result from at least 3 days after your exposure date, please bring both your vaccination card and your negative test result for admission to the J. Please note that you will not be able to complete this form; please show your vaccination card and negative test result to the greeter when you arrive.

    If you have been exposed to someone with a confirmed case of COVID-19 in the past 14 days and DO NOT meet both the vaccination and negative test result criteria above, we cannot grant you access to the J at this time.

    You can find a full list of our current COVID-19 protocols and procedures here. If you have any questions, please contact the appropriate person below:

    • Early Childhood School: Nicci Burrell at NicciB@sjcc.org  or 206-388-0825
    • J Camp: Samantha Hagen at SamanthaH@sjcc.org  or 206-829-2668
    • SJCC members: Dana Weiner at DanaW@sjcc.org or 206-829-2593

  • Based on your response, we cannot grant you access to the J at this time. The SJCC follows the CDC's travel guidelines. Please read more about the required post-travel quarantine for people who are not fully vaccinated here. We will gladly welcome you back into the building when you reach the end of your monitoring period.

  • Based on your response, we cannot grant you access to the J at this time. You can find a full list of our current COVID-19 protocols and procedures here. If you have any questions, please contact the appropriate person below:

    • Early Childhood School: Nicci Burrell at NicciB@sjcc.org  or 206-388-0825
    • J Camp: Samantha Hagen at SamanthaH@sjcc.org  or 206-829-2668
    • SJCC members: Dana Weiner at DanaW@sjcc.org or 206-829-2593

  • Child Health Declaration

  • Symptoms include:

    • Fever or chills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea

  • If your child has been exposed to someone with a confirmed case of COVID-19 in the past 14 days, but they are vaccinated and have proof of a negative COVID-19 test result from at least 3 days after their exposure date, please bring both their vaccination card and negative test result for admission to the J. Please note that you will not be able to complete this form; please show your child's vaccination card and negative test result to the greeter when you arrive.

    If your child has been exposed to someone with a confirmed case of COVID-19 in the past 14 days and DOES NOT meet both the vaccination and negative test result criteria above, we cannot grant them access to the J at this time.

    You can find a full list of our current COVID-19 protocols and procedures here. If you have any questions, please contact the appropriate person below:

    • Early Childhood School: Nicci Burrell at NicciB@sjcc.org  or 206-388-0825
    • J Camp: Samantha Hagen at SamanthaH@sjcc.org  or 206-829-2668
    • SJCC members: Dana Weiner at DanaW@sjcc.org or 206-829-2593

  • Based on your response, we cannot grant your child access to the J at this time. The SJCC follows the CDC's travel guidelines. Please read more about the required post-travel quarantine for people who are not fully vaccinated here. We will gladly welcome you back into the building when you reach the end of your monitoring period.

  • Based on your response, we cannot grant your child access to the J at this time. You can find a full list of our current COVID-19 protocols and procedures here. If you have any questions, please contact the appropriate person below:

    • Early Childhood School: Nicci Burrell at NicciB@sjcc.org  or 206-388-0825
    • J Camp: Samantha Hagen at SamanthaH@sjcc.org  or 206-829-2668
    • SJCC members: Dana Weiner at DanaW@sjcc.org or 206-829-2593

  • Thank you! Please click the button below to submit your COVID-19 Screening Form. Please check your email for confirmation and be prepared to show proof of submission when you arrive at the J. 

    You can find a full list of our current COVID-19 protocols and procedures here. If you have any questions, please contact the appropriate person below:

    • Early Childhood School: Nicci Burrell at  NicciB@sjcc.org  or 206-388-0825
    • J Camp: Samantha Hagen at  SamanthaH@sjcc.org  or 206-829-2668
    • SJCC members: Dana Weiner at  DanaW@sjcc.org  or 206-829-2593
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