Pre Chanukah for Kids

Parent Name*

First NameLast Name

Cell Phone Number*

Email*

example@example.com

Number of Children Joining*

1. Child Name*

First NameLast Name

Grade*

School

2. Child Name*

First NameLast Name

Grade*

School

3. Child Name*

First NameLast Name

Grade*

4. Child Name*

First NameLast Name

Grade*

School

5. Child Name*

First NameLast Name

Grade*

School

$18 Minimum Donation Per Child

ALL proceeds will go directly to families whose husbands are away at war defending and protecting our country of Israel.

Any donation of $25 or more IN ADDITION to the $18 per child will enter your family into a raffle for a $100 Amazon gift card!

$18 Minimum Donation Per Child*

USDMinimum donation: 1 Child - $18 l 2 Children - $36 l 3 Children - $54 l 4 Children - $72 l 5 Children $90

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country