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Purim with a beat

Purim with a beat

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Registration Form 

First Name

 

E-Mail

Last Name

 

Phone

How many Adults   How many Children?  
         
Cost: Child $15 ~ Adult $25 ~ Family $65
Sponsor the event:  $180 (includes family admission)  
Payment
CC Type   Card Number
Billing Address   City, State, Zip
Charge Amount   Exp Date
CVV

 

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