Contact Information
Attendee Information
Payment Information
Contact Information
Title
Title
Mr.
Mrs.
Ms.
Rabbi
Mr. & Mrs.
Dr. & Mrs.
Mr. & Dr.
Dr. & Dr.
*
First Name
*
Last Name
*
Address
*
City
*
Province
*
Postal Code
*
Email
*
Attendee Information
Guest Type
Number of Guests
Amount
Total
Family Membership - includes seats
1200.00
Individual Membership - includes seats
1100.00
Senior (+65) Membership - includes seats
1000.00
Day Care - HS Family Membership - includes seats
480.00
Family High Holiday Reservation only
360.00
Individual High Holiday Reservation only
180.00
Total
Payment Information
Reservation Amount
*
Optional Donation
$1,800 - Friendship Sponsor
$1,100 - Family Sponsor
$900 - Senior Sponsor
$770 - Silver Sponsor
$450 - HS Sponsor
$360 - Chai Sponsor
$180 - Donour
Other
Total Amount
*
Card Number
*
Card Expiration
Month
1 - January
2 - February
3 - March
4 - April
5 - May
6 - June
7 - July
8 - August
9 - September
10 - October
11 - November
12 - December
*
Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
*
Security Code
*
Same as above
Name on Card
*
Billing Address
*
Postal Code
*
Submit
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