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Recent Events 2017 5777-78

Purim on the Red Carpet

Sunday March 12, 6-9pm

Come dressed in Your Purim Finest or Funniest!
Full Name*

First Name Last Name
E-mail*
Phone Number*

Area Code Phone Number
Number Attending
Children Age 3-13 (we will have supervision for them)
Any special messages or dietary requirements

Payment*

Credit Card

Credit Card Type
Credit Card Number
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Amount: $18/adult $12/Child 3-12*

$
At the Door: $25
Should be Empty:

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