Family Chanukah Party - Form

Brotherhood/Sisterhood Hosts a
Family Chanukah Party
Saturday, December 28
5:00-8:00pm at Temple Shalom
5:30pm Havdallah Service
6:00pm Dinner & Games/Entertainment for Kids

Bring your Chanukiah and candles for a group lighting!

Dinner
Brisket, latkes, vegetable, salad, holiday desserts, and beverages
Vegetarian option available.

* Confirmation Email Address

* Number of Adults Attending

Please complete all fields for each adult.

Adult's First Name

Adult's Last Name

Mobile Number

Temple Shalom Member?

YesNo

Number of Children 0-18 attending

Please complete all fields for each child.

Child's First Name

Child's Last Name

Child's Age

Temple Shalom Member?

YesNo

* How many adult dinners (ages 13+)?

$15/person

How many dinners for children ages 5-12?

$8/person

How many dinners for children 0-4 years of age?

Free!

Number of vegetarian dinners requested

Total

* How did you hear of this event? Check off as many as apply, please.

* Photo Release--I consent to the use of images of anyone in our party as described below.

Please Select OneYesNoPrivacy and Use of Images Families may be photographed or videotaped as they participate in Temple activities, or they may be recorded in Temple Shalom video stream programs. On occasion, these images, and the identity of the persons depicted, may be used by Temple Shalom for educational, instructional, development and/or informational purposes in print, internet and digital media, including in news releases (e.g, Texas Jewish Post) and/or printed publications or materials, electronic publications, or websites. Temple Shalom will not sell images of Temple Shalom members or non-members or their families to third parties, and it will not use their images for promotional or advertising purposes that do not concern Temple Shalom and its programs.