1. Your Information Full Name* First Name Last Name Phone Number* Area Code Phone Number E-mail* 2. Attendees Number of Adult Attendees: Adult Names: Please name all the adults attending Number of Child Attendees: Child/ren Names: Please name all the children attending 3. DatesPlease note which services you will be joining us for. Rosh Hashana Eve Wednesday, Oct 2nd 7:00pm - Evening Services Rosh Hashana Day 1 Thursday, Oct 3rd 10:00am - Morning Services11:30am - Shofar12:30pm Kiddush Shofar in the Park Thursday, Oct 3rd Join us for a short prayer service, followed by Shofar blowing and Tashlich. At the new gazebo, Parkview Blvd and Shelburne Ln. 5:00pm Rosh Hashana Day 2 Friday, Oct 4th 10:00am - Morning Services11:30am - Shofar12:30pm Kiddush Yom Kippur Eve Friday, Oct 11th 6:30pm - Kol Nidrei, Evening Service Yom Kippur Day Saturday, Oct 12th 10:00am- Morning Services12:00pm- Yizkor5:30pm- Mincha and Ne'ilah7:30- Break-Fast Reminder: RSVP for dinner on the separate form Names and prayers for Rosh Hashana community prayer For the first time, we are collecting personal prayers to hold close on the bimah during the sounding of the Shofar. Prayers for academic success, financial success, health, long life, and for loved ones will be printed and placed in a folder on the bimah. All individual prayers of our community will be in one space for one moment, praying for each other individually and collectively. 4. Optional Donation Would you like to give a gift to Chabad to join in our High Holiday Campaign?* Sure, I'd love to help!No, thank you Thank you for considering a gift. High Holiday expenses will be almost $12,000. Please choose an amount that you would like to give!* $72$180$360$540$1800$3600 Total $0.00 Payment Credit Card Paypal Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2024202520262027202820292030203120322033 Expiration YearPaypal has been selected. Payment will take place on the next page.Billing Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Submit Should be Empty: This page uses TLS encryption to keep your data secure.