I would like to make reservations for the Kids in the Kitchen Purim Event on Sunday, February 23, 2020, for:

Child Reservation(s) - $8/child

Child Name 

Child Name  

Child Name  

Child Name  

Please charge my Credit Card in the amount of $

Please add 3.5% to cover credit card processing fees.

Title *
First Name *
Last Name *
Address Line 1 *
Address Line 2
City *
State
Zip Code *
Phone
This is my home business address.

 

Card Type *
Card Number *
Expiration Date *
CVV Security Code What's This?

 

 

Email Address *
Reconfirm Email Address *

 

* Denotes required field