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Register to join us for Lag B'Omer
How many people are you registering?
*
1
2
3
4
5
6
7
8
9
10
(including yourself)
Fill in your registration information on this page. If you are registering additional people, you will be able to enter their registration information after you complete this page and click "Review your registration".
Your Registration Info
First Name
*
Last Name
*
Email Address
Phone
*
Street Address
City
State
- select State/Province -
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Country
- select Country -
Australia
Canada
Israel
United Kingdom
United States
Postal Code
Event Fee(s)
Suggested Donation to help us cover the costs for this event: $25/Person $15/ Child/Student/Pensioner
Donation Amount
$ 1.00
Total for this participant
Credit Card
Card Type
- select -
Visa
MasterCard
Amex
Discover
Card Number
*
Security Code
*
Expiration Date
*
-month-
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
-year-
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
My billing address is the same as above
Billing Name and Address
Billing First Name
*
Billing Middle Name
Billing Last Name
*
Street Address
*
City
*
Country
*
- select -
Australia
Canada
Israel
United Kingdom
United States
State/Province
*
- select State/Province -
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Postal Code
*
Review your registration
Young Adult Chabad
admin@youngadultchabad.org
|
0400 770 613
|
Newtown, Australia
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