Full Name* First Name Last Name E-mail* Phone Number* Area Code Phone Number How many children will be attending? 1234 RSVP* $18 PER FAMILY | Sponsor $180 | Co Sponsor $100 $18 USD Total Charge $18.00 USD Payment Method Credit Card Paypal Other Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2025202620272028202920302031203220332034 Expiration YearPaypal has been selected. Payment will take place on the next page.If using CC on file put last 4 digits in comments box. Check? Mail Check payable to Chabad Comments? Questions? Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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