I am registering for:

The First Seder, Friday, April 19 at 7:00 pm
   
How Many Adults
How Many Children
   
First Name:
Last Name:
Phone:
Email:
   
Rates per Person
Adult $50
Child under 11 $35
Sponsor $500
   
Credit Card Info
Credit Card Type
Number
Exp. Date
CVV
Grand Total

I will send in a check payable to Chabad of Thousand Oaks.
Please send checks to:
1515 El Monte Drive, Thousand Oaks, CA 91362