Program Registration - ChabadatWiregrass.com

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Address:*

Phone Number:*

Area Code Phone Number
E-mail:*
Cost: Includes Hotel, All Meals & Programing
Double Occupancy $437.5 Per Person - Single Occupancy $650- Additional person in room $225
Number of Guests:*
Number of Rooms*
I would like to be a sponsor for this event:
Sponsorships:

Table Sponsor - $180Sponsor a Guest - $360Shabbat Sponsor - $1000Event Sponsor - $1800
Total

$0.00

Payment

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We accept Visa, MasterCard, American Express, Discover
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Expiration Month	Expiration Year

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