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Religious School Shabbat Dinner

Personal Information

* First Name

* Last Name

* Email Address

* Number of adults who will be attending

* Number of children who will be attending

Immediate Family

	1 person	$15.00
	2 people	$30.00
	3 people	$45.00
	4 or More immediate family members	$60.00

Guests (We welcome grandparents, aunts, uncles, cousins, friends, etc.) Please register these guests here.

Special Dietary Needs

If family members have special dietary needs (allergies, etc) or require a vegetarian meal, please email Liz Marlowe at [email protected] with that information so we can accommodate you!

Account Details

Enter your name and e-mail address for your confirmation:

*E-mail

*First Name

*Last Name

Payment Information

Account

Online Fee:

Credit Card

Name on Card

Card Type

Card Number

Expiration Date

Card Verification Number

Address Line 1

City

State/Province

Zip

Comments

Increase the amount by 2.5% to cover credit card fees. Please select YES to increase your payment.

Total: