Tot Shabbat Registration Information CBAJ and PJ Library present Tot Shabbat Friday Night Join us at 6 pm the third Friday of each month for Tot Shabbat, a special children's service led by Rabbi Feldman and Amy Drucker including Shabbat Sing-Alongs and Story Time, followed by a kid-friendly dinner and magical entertainment. $30 per family. 2nd Tot Shabbat: Friday evening, February 17Your Name* First Last Phone*Email* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How many adults are you registering?*012345How many children are you registering?*012345678Who's Coming?Adult 1* First Last Adult 2* First Last Adult 3* First Last Adult 4* First Last Adult 5* First Last Child 1 Name* First Last Child 1 Age*0123456789101112131415161718Child 2 Name* First Last Child 2 Age*0123456789101112131415161718Child 3 Name* First Last Child 3 Age*0123456789101112131415161718Child 4 Name* First Last Child 4 Age*0123456789101112131415161718Child 5 Name* First Last Child 5 Age*0123456789101112131415161718Child 6 Name* First Last Child 6 Age*0123456789101112131415161718Child 7 Name* First Last Child 7 Age*0123456789101112131415161718Child 8 Name* First Last Child 8 Age*0123456789101112131415161718Payment Information Please select from the following payment options:Would you like to sponsor this event?yesnoBe a co-sponsor for $180. Includes one family registrationevent co-sponsorship Price: $180.00 Quantity: Family Registrations Price: $30.00 Quantity: How will you pay?*Online with Credit Card or PayPalCheck sent into the shul officePlease be advised that we are charged a 2.2% transaction fee for credit cards and paypal. Please consider increasing your donation to offset fees Donation PayPal Fee PayPal 2.2% PayPal Total Shul Total $25.00 $0.30 $0.55 $0.85 $24.15 $50.00 $0.30 $1.10 $1.40 $48.60 $75.00 $0.30 $1.65 $1.95 $73.05 $100.00 $0.30 $2.20 $2.50 $97.50 Donation Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name Total $0.00 Please note that your registration is not complete until you have paid using PayPal. You will be redirected to PayPal when you click the submit button below. Once you have paid with PayPal, you will receive an email from CBAJ confirming your registration. If you do not receive that email, your registration is not complete. Please contact the office at email@example.com or (518) 489-5819 for assistance or if you have any questions.Please press the submit button below to continue with your event registration. Please note, your registration is not complete until the CBAJ office has received your check for the full amount. Please contact the office at firstname.lastname@example.org or (518) 489-5819 for assistance or if you have any questions.