1. Information: Full Name* First Name Last Name Phone Number* Area Code Phone Number E-mail* 2. Reservation: Tuesday • March 3 • Boarding 4:00pm departing 4:15pm • @ Blue Haven Marina Adults* Children 3. Optional Donation:The Purim event and Chabad activities in general are free of charge, Your donation is our source of support and not only allows us to keep our Chabad Center open, but to make it thrive! $1,800 - Purim Event Sponsor$1,000 - Purim Event Co-Sponsor$540 - Purim Gold Sponsor$180 - Purim Silver Sponsor Other Amount $ USD Payment Method Credit Card Paypal Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearPaypal has been selected. Payment will take place on the next page. Total $0.00 USD Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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