Day School 3rd Grade Shabbat Dinner RSVP

3rd Grade Day School Shabbat Dinner, Friday, March 1st

5:30 pm — 3rd Grade Family Shabbat Dinner
6:30 pm — Shabbat Service

Please register by Tuesday, February 19th.

Student Name
Teacher [Please select one]
 Ms. Jahoda
 Mr. Nathanson
 Ms. Smith
Parent Name
City, State, Zip
E-mail Address
Daytime Phone
Please indicate the names of the guests in your reservation.
No. of Adults @ $22 per person
No. of Children 6 years old and above @ $14 per child (please remember to include your 3rd grade Student)
No. of Children 5 years old or younger @ $5 each

Payment Information:

Type of Card
Name on Card
Card Number
Expiration Date
Billing Address
Total Payment Amount (DO NOT USE A $)
Student Name