Passover Second Seder- April 6th

*PLEASE FILL IN ONE (1 ) FORM PER HOUSEHOLD
*Deadline to register is Friday, MARCH 31st at 5 pm.
*After March 25th - price increases by $10 per person

* First Name

* Last Name

* Address

* City

* Province

* Postal Code

* Email

* Phone Number

ADULTS:

* ADULT ($110 taxes included)

* Names of Adults:

Number of Adult Pomegranate Glazed Salmon Meals

Number of Adult Quinoa Mushroom stuffed Acorn Squash Meals:

CHILDREN UNDER AGE 10

CHILDREN UNDER 10 YEARS OF AGE ($60 taxes included)

Names and Ages of each child under age 10

Number of Child Pomegranate Glazed Salmon meals

Number of Child Quinoa Mushroom Stuffed Acorn Squash

TOTAL:

If you selected "Other" where did you hear about the program?

I acknowledge the photo disclaimer below:

I acknowledge the photo disclaimer below:Photos of you may be taken during this event. Congregation Dorshei Emet may use these photos in synagogue publications, flyers and on the screens in the lobby. Please contact Cynthia Weinstein at executivedirector@dorshei-emet.org with questions.