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Kids in the Kitchen

Kids Challah Bake
Kids in the Kitchen @ 311 Seabreeze Av.
Sunday, January 9 | 1:30 p.m.

$25 (when registering in advance or $30 on day of event)
Registration Is Closed!
Number of Reservations*$25 per child
Child's Information
Child's Name*
First NameLast Name
Hebrew Name
Age*
School
Additional Children - RSVP Names & Ages
Parent's Name*
First NameLast Name
Phone Number*
Area CodePhone Number

AddressIf different than billing address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail*
I would like to receive news and updates by email
Facebook NameTo see pictures and updates
Is there any information concerning your child that is important for the directors of Kids in the Kitchen to know?
(ex: asthma, food allergies)
Do you give permission to use photographs of your child in print materials, on our website, emails and facebook?*
yesno
How did you hear about Kids in the Kitchen?*
Payment Information

Payment*

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Total
$0.00 USD
Should be Empty:

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