Name
(Required)
First
Last
Are you a Temple Shalom member?
(Required)
Yes
No
No (active duty military or war college)
No (student)
Contact
Email
(Required)
Phone
Children
Are you interested in childcare / childrens' programming?
(Required)
Yes
No
For how many children?
(Required)
1
2
3
4
5
6
7
8
9
Please select the services you're interested in for childcare/programming:
(Required)
Rosh Hashanah Morning Oct. 3
Rosh Hashanah Morning Oct. 4
Yom Kippur Morning Oct. 12
Select All
Tickets
Type of Tickets
(Required)
Family Tickets
Individual Tickets
Holidays to Attend
(Required)
Both Rosh Hashanah and Yom Kippur – $180
Just Rosh Hashanah – $100
Just Yom Kippur – $100
Holidays to Attend
(Required)
Both Rosh Hashanah and Yom Kippur – $80
Just Rosh Hashanah – $50
Just Yom Kippur – $50
Total to be Charged
Credit Card
(Required)
Cardholder Name
Card Details