Community Seder 1

Please register yourself in the form below. If you are coming with multiple people, please include their names in the notes section

Your Information and guests

First Name *

Last Name *

Email (Primary) *

Phone-Phone (Primary)

Street Address (Primary) *

City (Primary) *

State (Primary) *

Number of Adults

Number of Children

Names of Everyone attending *

Event Fee(s)

Adult Price Per Person (Insert Number of Adults attending)

$54.00

Child Price (Insert Number of Children Attending)

$18.00

Sponsorship Options ($180 or more includes tickets for 1 family)

Matzah - $ 54.00

Wine - $ 72.00

Seder Plate - $ 180.00

Haggadah - $ 360.00

Shulchan Aruch - $ 540.00

All the trimmings - $ 1,800.00

- none -

If you would like to donate an amount that is not an option above, please enter in the amount you would like to donate here

Other

Total

Authorize.net (Credit Card)

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *