YOUTH PROGRAM REGISTRATION

Child 1 Name: Age
Program Attending    
 
Child 2 Name: Age
Program Attending    
 
Child 3 Name: Age
Program Attending    
 
I would like to be a program sponsor

I would like to be a sponsor of all Chabad youth programs - $540

Payment Information

I Will send a check via mail

Please charge my credit card

Credit card # Expiration
Zip

CVV #

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