Club L'Chaim lunch at Adath Israel

* First Name

* Last Name

* Mobile Phone

* Email Address

* Address

* City

* Postal Code

* Are you a Club L'Chaim member at Adath Israel ?

I am a Club L'Chaim memberI am not a Club L'Chaim memberI am not sure

* How many people will be attending the Lunch on June 27th?

Member

Non-member

Would you like the lasagna or salmon meal?

Lasagna mealSalmon meal
Please choose which meal you would prefer

If you are signing up for more than one person, please let us know who is having which meal

Please list the full names of all who will be attending

Allergies?

Please let us know of any food allergies. Please also indicate the severity of the allergy.

Total Cost

Tue, 23 April 2024 15 Nisan 5784