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CKids Clubs

Full Name*
First Name Last Name

Address*

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

E-mail*
Phone Number*
Number of children being registered:*
Child's Name*
Child's Age*
Child Name 2*
Child's Age*
Child Name 3*
Child's Age*
I would like to sponsor the following event:

Shofar Sound LabStreet Style SukkotMiracle Makers' Olive PressTu B'shvat Family ExperiencePurim PatisserieThe Seder SpellbookThe Sinai Climb
Please accept my sponsorship of:*

Contributor $72Co-sponsor $180Sponsor $500
Sponsor a child's membership:

$75
Total

$0.00
Please confirm:*

I acknowledge that there is no refunds and that I will need to RSVP for each event at no charge.

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

Should be Empty:

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