High Holidays Registration Form – The Chai Centre

Yom Kippur Registration Form

Email *

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Cell Phone *

Please select all that apply. *

Rosh Hashana Services
Rosh Hashana Lunch - Shabbos
Yom Kippur

Voluntary Donation *

No Donation - $0.00
Donation 1 - $100.00
Donation 2 - $180.00