Rabbi Gala Dinner

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* First Name

* Last Name

* Email Address

* Mobile Phone

* How many Adults are coming to dinner?

How many children under 12 are coming to dinner?

Adult 1 Full Name

Adult 2 Full Name

Adult 3 Full Name

Adult 4 Full Name

Child 1 Full Name & Age

Child 2 Full Name & Age

Child 3 Full Name & Age

Child 4 Full Name & Age

Please list who you would like to be seated with-

Total Fee

Fri, February 3 2023 12 Sh'vat 5783

Temple Avodah

3050 Oceanside Road

Oceanside, NY 11572