Chabad of the Town
presents

Rosh Hashana: September 6-8
Yom Kippur : September 15-16

Sukkot : September 20-26

Simchat Torah : September 27-29

ב"ה

RSVP

Reservation Selections
In this form you can reserve
- High Holiday Seats
- Kaparot
- Yizkor Book/Nachala
- Sponsor a person or family for the High Holidays
Contact Info
Full Name*
First NameLast Name
E-mail*
Phone Number*
Area CodePhone Number

AddressIf new to Chabad TMR or moved to new address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

High Holiday Seat Reservations
Seat Options
Annual Partnership - $770Individual Seat - $180Family - $360
Please seat me next to
Total Amount of People*
Minyan*
ChabadSepharad
Person 1
Jewish Name
Mother's Jewish Name
Adult/Child
AdultChild (under 12)
D.O.B
MonthDayYear
Jewish
By BirthBy Conversion
Kapparot$25
YesNo
Relation to you
SelfSpouseChildParentOther
Person 2
Full Name
First NameLast Name
Jewish Name
Mother's Jewish Name
Adult/Child
AdultChild (under 12)
D.O.B
MonthDayYear
Jewish
By BirthBy Conversion
Kapparot$25
YesNo
Relation to you
SelfSpouseChildParentOther
Person 3
Full Name
First NameLast Name
Jewish Name
Mother's Jewish Name
Adult/Child
AdultChild (under 12)
D.O.B
MonthDayYear
Jewish
By BirthBy Conversion
Kapparot$25
YesNo
Relation to you
SelfSpouseChildParentOther
Person 4
Full Name
First NameLast Name
Jewish Name
Mother's Jewish Name
Adult/Child
AdultChild (under 12)
D.O.B
MonthDayYear
Jewish
By BirthBy Conversion
Kapparot$25
YesNo
Relation to you
SelfSpouseChildParentOther
Add extra names:
Yahrzeit/Nachala Info & Yizkor Book (suggested $36 per name)
Yizkor Options
Name 1
Name
First NameLast Name
Hebrew Name
Father's Hebrew Name
Date of Passing
MonthDayYear
Time of Passing
Before SunsetAfter Sunset
Relation to you
Include in Yizkor/Nachala Booklet$36
YesNo
Name 2
Name
First NameLast Name
Hebrew Name
Father's Hebrew Name
Date of Passing
MonthDayYear
Time of Passing
Before SunsetAfter Sunset
Relation to you
Include in Yizkor Booklet$36
YesNo
Name 3
Name
First NameLast Name
Hebrew Name
Father's Hebrew Name
Date of Passing
MonthDayYear
Time of Passing
Before SunsetAfter Sunset
Relation to you
Include in Yizkor Booklet$36
YesNo
Payments & Donations
Payment Plan*
I would like to pay my balance in full nowI would like to pay in 3 installmentsI would like to pay in 12 installments
I would like to sponsor
Individual - $180Family - $360Shofar in the Park - $250Simchat Torah - $180
Total
$0.00