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Youth Baby Loves Shabbat

Baby Loves Shabbat Registration

Mommy's Name
First Name Last Name
Baby's Name
First Name Last Name
Baby Birth Date

Month Day Year
Allergies or Dietary Restrictions
E-mail
Which classes you will be attending:

4/305/075/145/215/286/116/18
$18 per Class

$65 Full Session
Amount

$18$36$54$65
Total

$0.00

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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