Passover Seder Reservations First Name: Last Name: Address: City: State: Zip: Phone #: Email Number of people attending: *Adults: $55 per Adult per Seder *Children: $25 for Children 4-11. Per Seder. Children 3 and younger are free. Benefactor $180 Sponsor $360 First Seder April 22 - 7:30 pm Second Seder April 23- 8:15 pm Both Sedorim yes/no Payment information I will pay with a credit card check/cash Billing Information Credit Card Type MasterCard Visa American Express Discover Card Number Expiration Date 01 02 03 04 05 06 07 08 09 10 11 12 2011 2012 2013 2014 2015 2016 Security Code Signature of name on card Total $ * The Price of $55 adult $25 for children is subsidized for Passaic County Residents only. All others, $100 adult $50 Children per Seder Please mail check to the Chabad Center 194 Ratzer Road Wayne NJ 07470 in time for it to arrive by April 19th This page uses 128 bit SSL encryption to keep your data secure.