Pesach Seder Booking Form

 A night to remember.

Wednesday, April 8th 2020

  Please Fill out the following form to RSVP 

 

 

Name:*
Address:*
City:*  STATE:*  ZIP:* 
Phone:*
Email:*

 


Please list name of attendees* 

Adults -    $65

Children (ages 3-10) -    $40

 

Credit Card Type 

Credit Card Number  

Expiration Date: Month  Year 

Total Amount:*  

Credit card charge will appear as Chabad On Wheels.


*Denotes Required Field