1. Your Information Full Name* First Name Last Name Phone Number* Area Code Phone Number E-mail* 2. Attendees Number of Adult Attendees: Adult 1 First Name Last Name Adult 2 First Name Last Name Adult 3 First Name Last Name Adult 4 First Name Last Name Number of Child Attendees: Child 1 First Name Last Name Child 2 First Name Last Name Child 3 First Name Last Name Child 4 First Name Last Name 3. DatesPlease note which services you will be joining us for. Form Date Month Day Year Rosh Hashana Eve Friday, Sept. 11 7:15pm - Evening Services Reminder - Friday September 11th: RSVP for dinner on the separate form Rosh Hashana Day 1 Shabbat, Sept 12 10:00am - Morning Services11:30am - Children's Program1:00pm - Kiddush Shofar in the Park Sunday, Sep 13, 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 Sunday, Sept. 13 10:00am - Morning Services11:30am - Children's program12:00pm - Shofar Sounding1:00pm - Kiddush Yom Kippur Eve Sunday, Sept. 20 7:00pm - Kol Nidrei, Evening Service Yom Kippur Day Monday, Sept 21st 10:00am - Morning Services12:30pm - Yizkor6:00pm - Mincha and Ne'ilah8:00pm - Break-Fast Names and prayers for Rosh Hashana community prayer We are once again 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 Month2026202720282029203020312032203320342035 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.