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Reservation Form

Reservation Form

HOLIDAY RESERVATION FORM

 

Your Info
First Name
Last Name
Address
City
State
Zip Code
Phone
Email
 
Seat Reservations
Amount Adult Attendees
Amount of Children Attendees
Adult Name 1
Child Name 1
Adult Name 2
Child Name 2
Adult Name 3
Child Name 3
Adult Name 4
Child Name 4
Adult Name 5
Child Name 5
Adult Name 6
Child Name 6
 
High Holiday Services I plan to attend
Please check all that apply.
 
Day 1 Rosh Hashanah
September 20/21
Day 2 Rosh Hashanah
September 22
Yom Kippur
September 29/30
    Neilah Service
 

 

Optional Donation
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Payment Info
Please submit your billing information below.
No one will be turned away for inability to pay. Your confidentiality is crucial to us.
Card Number
Expiration
CVV Code
Total Amount to Charge Card

Please make checks payable to:

Chabad of Homestead
8460 SW 198th St
Miami, FL 33189


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