Chabad of Golden Beach

High Holidays Reservation Form

ONLY FOR MEMBERS THAT RENEWED THEIR MEMBERSHIP TODAY

Due to limited space Registration for Main sanctuary will be on a
"First come, Fist saved" basis

First Name:	A value is required.
Last Name:	A value is required.
Spouse	A value is required.
Address:	A value is required.
Address 2:
City:	A value is required.
Zip Code:	A value is required.
Home Phone:	A value is required.
Cell Phone:
E-Mail:	A value is required.
Ashkenazic Minyan Sephardic Minyan



Member Seats $180 each name - Children: $100 each
Men Seats names:
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Women Seats names:
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Extra Seats $100 for direct Family Children and Parents:
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PAYMENT
Total Due: $ A value is required.
Credit Type:	A value is required.
Card Number:	A value is required.
Expiration Date:	A value is required. A value is required.



Due to limited space Registration for Main sanctuary will be on a "First come, Fist saved" basis