High Holidays Registration Step 1 of 6 16% EmailThis field is for validation purposes and should be left unchanged.Name(Required) First Last Phone(Required)Email(Required) Enter Email Confirm Email Membership Status(Required) Member Non-Member Membership Type(Required) Full Family Membership Single Membership Included Seats (Family Membership) Quantity(Required) Price: $0.00 Quantity Maximum of twoIncluded Seats (Single Membership) Quantity(Required) Price: $0.00 Quantity Maximum of oneIncluded Seats (Family Membership) - Name Listing(Required)Please list the names of adult members (one per line) that are eligible to attend under the family membership. NOTE: A maximum of two adults are included. Additional adults are billed at $136 per person. Please use the additional seating options to indicate the additional seats requested.Included Seat (Single Membership) - Name Listing(Required)Please list the name of the adult member (one per membership) that is eligible to attend under the single membership. NOTE: A maximum of one adult is included. Additional adults are billed at $136 per person. Please use the additional seating options to indicate the additional seats requested.Additional Member Adult Seats Requested (23+)?(Required) Yes No Would you like to to request additional seats for adults?Additional Member Youth Seats Requested (22 & Younger)?(Required) Yes No Would you like to to request seats for youth members?Additional Seats (Adult - 23+) Quantity(Required) Price: $136.00 Quantity Additional Seats (Youth - 22 & Younger) Quantity(Required) Price: $36.00 Quantity Additional Seats (Adult - 23+) - Name Listing(Required)Please list the names of the additional adults that will be attending with your family.Additional Seats (Youth - 22 & Younger) - Name Listing(Required)Please list the names of member youth that will be attending with your family.Non-Member Adult Seats (23+) Quantity(Required) Price: $200.00 Quantity Non-Member Youth Seats (22 & Younger) Quantity(Required) Price: $36.00 Quantity Non-Member Adult Seats (23+) - Name Listing(Required)Please list the names of adults that will be attending (one per line).Non-Member Youth Seats (22 & Younger) - Name Listing(Required)Please list the names of youth that will be attending (one per line). Note: If no youth will be attending, please enter "N/A". Do you have special seating requirements/requests?(Required) Yes No If a request is made to be seated with specific individuals, it is advisable to submit all requests at the same time and as early as possible. Please keep in mind that seat requests are filled in the order that we received them. We will do our best to honor requests.Special Seating Requirements/Request Detail(Required)Please use this field to indicate any special seating requirements and/or requests. If you are requesting to be seated with specific congregants, please include their names as part of your request. Do you wish to add Non-Member Individuals to the Yizkor Roster?(Required) Yes No Once again for Yom Kippur, we will be publishing our Yizkor Roster of Remembrance. The Roster will automatically include the names of individuals who were Or Hadash/White Meadow Temple members at the time of their death. Other individuals can be listed in the Roster for a donation of $18.00 per name. The Roster will be used not only on Yom Kippur, but also at the subsequent Yizkor services on Shmini Atzeret, Pesah and Shavuot.Yizkor Roster Listings Quantity(Required) Price: $18.00 Quantity Individual Names (One Per Line)(Required)Please list the name(s) of your loved ones that you would like to be included in the Yizkor Roster of Remembrance for the upcoming year 5785. Do you require Babysitting for your child?(Required) Yes No Or Hadash provides free babysitting with age-appropriate holiday activities and snacks for your children up to the age of 6 years.Please select the days you require babysitting(Required) Rosh Hashanah - Tuesday, September 23 Rosh Hashanah - Wednesday, September 24 Yom Kippur - Thursday, October 2 Babysitting begins at 10:30am and ends at 12:30pm.Child(ren) & Age(s) - (One Per Line)(Required)In the event of an emergency, all children ages 1-6 must wear name tags that include the child’s name, parent(s) name and seat location. Total Registration Fee Based on the items selected on this form, this is the total amount due.Credit Card Processing Fee Price: $0.00 PayPal/Credit Card Payments attract a 3% fee to cover processing costs.Please select your payment method PayPal/Credit Card I will send a Check
