Holiday Registration form

Full Name*
First Name Last Name
E-mail*
Phone Number*

Area Code Phone Number
Rosh Hashanah Dinner $54 Kama'aina $36 Adult $18 Kids
Number of Attendees
visitor
Adult Kama'aina
Children Kama'aina
High Holiday Donation , help support Judaism on Maui NO ONE WILL BE TURNED AWAY DUE TO LACK OF FUNDS

$54 USD$100 USD$180 USD$360 USD$540 USD$1080 USD
Total Charge

$0.00 USD

Payment Method

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

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