2015/16 YOUTH PROGRAMS REGISTRATION

Child 1 Name: Age
Program Attending  
 
Child 2 Name: Age
Program Attending  
 
Child 3 Name: Age
Program Attending  
 
I would like to help Chabad offer these programs to every Jewish youngster!!!
I would like to be a program sponsor - $360
I would like to be a partner in all 2014/15 youth programs - $1000
*Email:

Payment Information

I Will send a check via mail

Please charge my credit card

Credit card # Expiration
Zip

CVV #

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