Chai Hebrew JCM

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Wednesday January 29th

Drop off 2:30PM

Pick Up 5:45PM
Full Name*
First Name Last Name
Number of Children*
Name of Child*
Child #2*
Child #3*
Child #4*
I hereby grant my child/ren permission to attend the Jewish Children's Museum with Chai Hebrew*

YesNo
Optional Donation We appreciate donations to help cover the costs

$18$36$50$72
Total

$0.00

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
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Name on Card
Expiration Month	Expiration Year

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