Please fill in and return this sheet with payment to reserve your seat(s) for the Seder:

Name:                                                                                                        

Address:                                                                                                    

Telephone Number:                                                                                   

Number of persons attending in your party:                                    

Number of children attending under 5 years old                   

Number of adults attending:                                                   x  $15.00   

Number of children (5-12yrs) attending:                                x  $10.00   

Total you are sending:                                                             $