Chanukah Glow in the Dark Disco

Program ends at 5:00pm at Chabad Sutton, 409 East 58th Street with Menorah Lighting, donuts and treats.
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First Name Last Name
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Phone Number*

Address

We are a CHS/Chabad Club Member family
Number of Adults*
Number of Children*
Number of Adults*
Number of Children* $10/Child
Child 1 Name*

First Name Last Name
Child 1 Age*
Child 1 School Attending*
Child 2 Name*

First Name Last Name
Child 2 Age*
Child 2 School Attending*
Child 3 Name*

First Name Last Name
Child 3 Age
Child 3 School Attending
Child 4 Name*

First Name Last Name
Child 4 Age*
Child 4 School Attending*
Would you like your child to try out Hebrew School on Tuesday December 12?
Would you like your child to be picked up from PS 59 for this event? (ages 6+ only)
If yes please note your child's dismissal time and teacher.*
*

I confirm that my child does NOT have any food allergies or other relevant health concerns.
Total

$0.00

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We accept Visa, MasterCard, American Express, Discover
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