Old York Road Kehillah Purim Carnival Registration – Jewish Federation of Greater Philadelphia

Thank you for your interest in attending the Jewish Federation’s Old York Road Purim Carnival on Sunday, March 16 from 11 a.m. – 3 p.m. at Reform Congregation Keneseth Israel.

Please fill out the following information. For more information about the event, click here.

By attending this event, you agree to the Jewish Federation of Greater Philadelphia’s Terms and Conditions.

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Contact Information

First Adult Name*

First Last

First Adult Email*

First Adult Cell Phone*

Billing Address*

Address Line 1 Address Line 2 City State ZIP Code

First Adult Home Address*

Same as billing address

Check this box if registering a second adult

If you have more than two adults in your party, please fill out an additional registration form.

Second Adult Name*

First Last

Second Adult Email*

Second Adult Cell Phone*

Second Adult Home Address*

Same as previous

How many children (under age 18) will be joining you?*

Please enter a number greater than or equal to 0.

What synagogue/Jewish organizations are you connected to? (Write N/A if this does not apply to you)*

Would you like to contribute $10 to make it possible for another member of the community to attend our Purim Carnival?*

Yes, I will contribute $10 towards a ticket for another attendee to help keep this event accessible for all community members.

Credit Card Information

1 Adult, 0 Children

Price:

1 Adult, 1 Child

Price:

1 Adult, 2 or more Children

Price:

2 Adults, 0 Children

Price:

2 Adults, 1 Child

Price:

2 Adult, 2 or more Children

Price:

Support Another Community Member

Price:

Total Cost

Credit Card

Card Details

Cardholder Name

IN LIEU OF A SIGNATURE, PLEASE ENTER YOUR FULL NAME AND THE NAME(S) OF ANY MINOR CHILD(REN) ATTENDING THIS EVENT OF WHOM YOU ARE THE PARENT AND/OR LEGAL GUARDIAN.*

As a supporter of the Jewish Federation, please keep me updated using the information provided above to reach me through:

Digital/email

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