Passover Registration

Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email Address(Required)

Food Allergies and/or Sensitivities

Meat or Pareve Dish to Contibute to Meal:

Total Number of Guests:(Required)

I will Bring my own Seder Plate(Required)

Passover Reservation Type(Required)

No family or individual will be turned away due to financial hardship. Please contact our treasurer to make arrangements at treasurer@levshalomaz.org

If you prefer to send a check, please select:

Individual - $10

Couple - $15

Family - $20

Please Send Checks to: Congregation Lev Shalom, PO Box 31058, Flagstaff, AZ 86003

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