PURIM REGISTRATION FORM

This form is currently closed.

Two Fun Purim Events
Absolut Purim - Thursday, March 13 @ 7pm. No RSVPs necessary.
Purim Shabbat Feast - Friday, March 14 @ 5pm - $40 per adult, $15 per child, max $110 per family
Event sponsor - $180, $360, $540
Full Name*
First Name Last Name
E-mail*
Phone Number*
Please enter EITHER number of adults and kids attending and the form will calculate the total:
OR put 1 under Family max, you'll be charged $110 per family
How many adults $40 ea
How many kids, 12 and under $15 ea
Family max $110 ea family
PAYMENT
Event Sponsor $180, $360, $540

$
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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Two Fun Purim Events