2016 Bnei Akiva Blackout (NON-Members)

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2016 BNEI AKIVA BLACKOUT!
NON-Member Sign Up

When: Motzei Shabbat, 10/22
What Time: 8:30-10:00 PM
Where: Shaare Tefilla
Who: All 7th & 8th Graders

*NON-Member Cost: $14.00 Per Person

*MEMBERS/Bnei Akiva refers to having a Bnei Akiva membership, and NOT to your Shaare membership.

Please fill out the form below to
REGISTER & PROCESS PAYMENT!

* Parent's Last Name

* Parent's First Name

* Phone Number

* Email Address

Bnei Akiva NON-Members: Sign Up Below

# of Children (NON-Member Cost: $14.00 Ea)

CHILDREN'S INFORMATION

Last Name (Child 1)

First Name (Child 1)

Age

Grade

Last Name (Child2)

First Name (Child2)

Age

Grade

Last Name (Child3)

First Name (Child3)

Age

Grade

Last Name (Child4)

First Name (Child4)

Age

Grade

Last Name (Child5)

First Name (Child5)

Age

Grade

Amount Due

Thu, April 18 2024 10 Nisan 5784