Purim with Chabad of Antarctica

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Full Name*
First Name Last Name
E-mail*
Phone Number*

Area Code Phone Number
Which event will you be attending?

Megillah ReadingHoliday MealsHamentashen Bake
How many adults are attending?
How many kids are attending?
Name of Adults
(1) Adult Full Name*
First Name Last Name
(2) Adult Full Name*
First Name Last Name
(3) Adult Full Name*
First Name Last Name
(4) Adult Full Name*
First Name Last Name
(5) Adult Full Name*
First Name Last Name
Name of Kids
(1) Kid Full Name*
First Name Last Name
(2) Kid Full Name*
First Name Last Name
(3) Kid Full Name*
First Name Last Name
(4) Kid Full Name*
First Name Last Name
(5) Kid Full Name*
First Name Last Name
Would you like to donate to Chabad?

YesNo
Donation Amount

$18 USD$54 USD$180 USD$360 USD$1000 USD
Total Charge

$0.00 USD

Payment Method

Credit Card Zelle/Cash

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