Welcome to our Purimania 5780 Reservation Form

A Celebration for the Entire Family 
Featuring the amazing, funny and likeable Joshy K and his incredible Mentalist show plus decorate your own Hamantashen, Paint a Purim mask, build a gragger and more....Entertainment & Food, Prizes for Kids in costume!  

ENJOY PURIM WITH MELVILLE CHABAD!
TUESDAY, MARCH 10, 2020, 5:30 pm 
at the Huntington Hilton, 598 Broad Hollow Rd, Melville, NY 11747

For more information call Melville Chabad (631) 385-2424

PERSONAL INFORMATION

Last Name   City
First Name   State
Address   Zip
Email   Phone
ADULT / CHILDREN RESERVATIONS

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Adults     Children  
Adult Name 1   Child Name 1
Adult Name 2   Child Name 2
Adult Name 3   Child Name 3
Adult Name 4   Child Name 4
Adult Name 5   Child Name 5
Adult Name 6   Child Name 6

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Purchase Payments & Optional Contribution

 Cost: Adults: $18, Children: $12, Family: $54 
Mordechai Sponsor: $180 - Queen Esther Sponsor: $360

Please charge my:
VISA  MasterCard  American Express   Discover
Card Number:
Exp. Date: mm/yyyy   /  CVV Code  Card Zip code
TOTALS  *Optional promo code  
 
 
Total Amount to be Charged: 

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