BERS Family Shabbat Dinner

Date and time (24-hour clock):

Registration Information

First Name

Last Name

Email:

Address

City

State

Zip Code

Ticket Information

Adults/Teens

at $12 each

Children 3-12 years old

at $9 each

Children under 3

are no charge

Beth El Member Family Ticket

at $45

If the total cost for your member household is more than $45, please select this ticket instead.

Beth El Non-Member Family Ticket

at $60

If the total cost for your non-member household is more than $45, please select this ticket instead.

*Please note that the family ticket is only for members of your household. If individuals attending with your group do not live at the same physical address, you will need to purchase additional tickets for them.

Total Amount:

Member family ticket: how many people total are attending?

Please list the names of all attendees including the ages of children.

Number of vegan meals required

Please let us know if anyone in your party has any allergies, dietary concerns, or special instructions. (Please include the name(s) with the information.)

Please select a payment method:

Electronic Check (ACH) Payment

Bank Routing Number

Bank Account Number

Confirm Bank Account Number

Bank Account Type

Bank Name

Account Holder Name

There is a 3% transaction fee for paying by credit card. There is no fee for paying by eCheck.

I understand and agree to the 3% transaction fee.

3% Donation Fee Information

Fee

New Total

Credit Card Payment

Credit Card Number

Verification Code

Card Expiration (MM)

Card Expiration (YYYY)

Use a different billing address?

Billing Street

Billing City

Billing State

Billing Zip Code

Please click the Submit button only once to avoid being charged multiple times. No refunds.

Total Number of Attendees

Authnet_Hidden_Fields