Purim in Candyland

Information

First Name

Last Name

Street Address

City

State

Postal Code

Phone

Number of Adults

Number of Children

Names of Everyone attending *

Event Fee(s)

Regular Price After February 15- $18 per adult | $15 per child (2-12) with $72 family max

Price per Adult

$15.00

Please enter in the number of children/adults who will be attending. If you are attending as a family, choose "Family Price"

Price Per Child (2-12)

$10.00

Family Price

Family Price (Immediate members only) - $ 54.00

Donations include Event Registration for 1 Family

Donation Options

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 *