8th Grade Shabbaton 5785

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8th Grade Shabbaton 5785
E-mail*
Student's Full Name*
First Name Last Name
8th Grade Shabbaton (Actual cost per student: $120)*

$65
Consent*

I give Permission for my daughter to join in the 8th grade Shabbaton activities. I authorize any medical care, should it be necessary chas v'shalom.
Deposit*

I will send in a $20 check to the office for an accidental deposit.
Parent Signature (Full Name )*
First Name Last Name
I'd like to help sponsor towards the cost of the Shabbaton

$180$360
Total

$65.00

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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