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CKids Club Registration

CKids Club Registration Form

Note: Chabad Hebrew School students DO NOT need to register

Use this form to register other children or to be a sponsor.

Sponsors (to date):
Sponsors of $100 or more will be listed here
Full Name
First Name Last Name
E-mail*
Phone Number

Area Code Phone Number
How many children (ages 2-12)? $10 per child
Comments?
Donation / Sponsors Donations $100+ will be listed as event sponsors

$54$100$180$360$540$800$1000$1800$3600
Total

$0.00
Yes, I'd like to donate the cost of processing this transaction by adding 3%

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

I would like to receive news and updates by email
Should be Empty:

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