Kids in the Kitchen

First Name of Parent*
First name of Child *

Child's Birthday *
Child # 2 Name:
Child # 2 Birthday:
Last Name *
Address *
City *
Postal Code *
Phone *
E-mail *

$10 per child

Payment Information:
Security: Chabad RC of Thornhill Woods
uses technology that encrypts all information from the end-user to the web server.

Number of children attending:
Date Attending:
Payment Amount: $

Card Type:
Card Number :  

Expiration Month:  Expiration Year :