Pre Pesach Shabbat Dinner - UptownChabad.com

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Pre Pesach Shabbat Dinner

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Name*

First Name Last Name
Total Number of Children (ages 3 - 12)* Please note that the caterer charges adult fees for youth ages 13 and up. Children 2 years of age and younger are free.
Total Number of Adults (ages 13 and up)*
Names of Adults* One name per line
Names and Ages of Children* One name/age per line

If no children in rsvp, write N/A
Phone*

Area Code Phone Number
E-mail*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Optional Donation The cost of the Shabbat dinner is subsidized to help make it affordable for all. Please consider making a donation to help cover the costs and sponsor those in need.

$50$180$500$1800$5000
Total

$0.00

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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