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Passover Seder Registration

Passover Seder Registration

Passover Seder Registration

Title:

First Name:

Last Name:

Email:

Which night of the Seder: First night April 10   Second night April 11

How many are attending? Adults: Children:

You have my information!(skip next section)

Address:

City:

State:

Zip:

Phone No:

Payment Information:

Card type:

Name on Card:

Card No:

CVV Security Code:

Billing zip code:

Expiration date:

Email receipt to:

Please charge my card $36 per adult $20 per child

Please charge my card this amount

No one will be turned away due to lack of funds.

Comments:

I would like to be added to the mailing list

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