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To obtain free entrance you must print this receipt

Adults Children:

$ I would like to sponsor this event (you will be entered into the Caribbean Vacation Raffle)
$ I would like to advertise my business at this event

All contributions are tax-deductible.

Names of those attending:
Address:
City: State:
Zip:
Home phone number:
Cell Phone Number
E-mail:
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Payment Method If Applicable

Please charge my credit card

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Card number:
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Please make checks payable to
Chabad @ the Beaches
521 A1A N Ponte Vedra, FL 32082