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TBT Member High Holiday Registration (2023)
MEMBER INFORMATION
Primary Name
(Required)
First
Last
Primary Email
(Required)
Primary Cell Phone
(Required)
Are you a PILLAR member?
(Required)
Yes
No
How many Adult Members (18 and older) plan to attend High Holiday services?
Select
1
2
3
4
Please provide Adult Member names and phone numbers below for security purposes.
Adult Member 2 - FULL NAME
(Required)
Adult Member 2 - CELL PHONE
(Required)
Adult Member 3 - FULL NAME
(Required)
Adult Member 3 - CELL PHONE
(Required)
Adult Member 4 - FULL NAME
(Required)
Adult Member 4 - CELL PHONE
(Required)
Please indicate the number of Member children attending High Holidays below.
# of Children ages 13 to 17
Select
1
2
3
4
5
# of Children ages 6 to 12
Select
1
2
3
4
5
# of Children ages 5 and under
Select
1
2
3
4
5
MEMBER GUESTS
TBT Members may bring guests to High Holiday services for $100 per Adult Member Guest (18 and older) per holiday. There is no cost for children 17 and under.
Please indicate the number of Member Guests who will join us for High Holidays below.
ROSH HASHANAH - Adult Guests (18 and over)
Select
1
2
3
4
5
ROSH HASHANAH - Child Guests (17 and under)
Select
1
2
3
4
5
YOM KIPPUR - Adult Guests (18 and over)
Select
1
2
3
4
5
YOM KIPPUR - Child Guests (17 and under)
Select
1
2
3
4
5
Please provide the names and email addresses for all Adult Guests below for security purposes.
ROSH HASHANAH Adult Guests - FULL NAMES
(Required)
YOM KIPPUR Adult Guests - FULL NAME(S)
(Required)
ROSH HASHANAH Adult Guests - EMAIL ADDRESS(ES)
(Required)
YOM KIPPUR Adult Guests - EMAIL ADDRESS(ES)
(Required)
SERVICE ATTENDANCE
Please indicate which services you and your guests plan to attend by entering the TOTAL number of persons (member adults, member children, adult guests, and child guests) for each service below. This information assists us with planning and security.
EREV ROSH HASHANAH SERVICE - Sept. 15 at 7:30pm
(Required)
Select
1
2
3
4
5
6
7
8
9
10
ROSH HASHANAH FAMILY SERVICE - Sept. 16 at 9am
(Required)
Select
1
2
3
4
5
6
7
8
9
10
ROSH HASHANAH MORNING SERVICE - Sept. 16 at 10:15am
(Required)
Select
1
2
3
4
5
6
7
8
9
10
KOL NIDRE SERVICE - Sept. 24 at 7:30pm
(Required)
Select
1
2
3
4
5
6
7
8
9
10
YOM KIPPUR FAMILY SERVICE - Sept. 25 at 9am
(Required)
Select
1
2
3
4
5
6
7
8
9
10
YOM KIPPUR MORNING SERVICE - Sept. 25 at 10:15am
(Required)
Select
1
2
3
4
5
6
7
8
9
10
YOM KIPPUR PM/N'ILAH SERVICES - Sept. 25 at 4/5:15pm
(Required)
Select
1
2
3
4
5
6
7
8
9
10
BREAK-THE-FAST
TBT hosts a Break-the-Fast dinner following the N'ilah service on Yom Kippur (approximately 6pm). Please indicate if you would like to attend below by selecting the number of adults and children who will attend.
# of Adult(s) (18 and older) for Break-the-Fast
Price:
$30.00
Quantity:
# of Children (ages 13 to 17) for Break-the-Fast
Price:
$20.00
Quantity:
# of Children (ages 6 to 12) for Break-the-Fast
Price:
$15.00
Quantity:
# of Children (ages 5 and under) for Break-the-Fast
Price:
$0.00
Quantity:
Please indicate any dietary needs below so we have appropriate options for everyone.
Food Allergies
Peanuts
Tree Nuts
Dairy or Milk
Other
Dietary Needs
Dairy Free
Gluten Free
Vegetarian
Vegan
Other
If you selected "Other" for dietary needs or food allergies, please specify below:
SPECIAL CONTRIBUTIONS
We welcome contributions to support our congregation. Your generosity is much appreciated. Donations of any amount allows you to place an announcement in our High Holiday Yizkor Memorial Booklet as well.
Would you like to make a SPECIAL CONTRIBUTION to TBT?
Yes
No
I would like to contribute:
Chai
Double Chai
Quadruple Chai
Other
If other, please list amount below:
HIGH HOLIDAY BOOKLET ANNOUNCEMENT
Title
TBT Pillar Members and anyone making a Special Contribution are invited to provide a short announcement (150 characters or less) in memory of a loved one, honoring a parent, congratulations for an accomplishment, or just wishes for a Happy New Year! Please type your announcement below.
YIZKOR INFORMATION
TBT publishes a Yizkor memorial booklet which is provided during the Yizkor service. Names from prior years and those listed on our Memorial Wall are automatically included.
Would you like to add or update names listed in our Yizkor booklet?
(Required)
Yes
No
1. In Loving Memory of
(Full English Name)
1. Relationship to You
(Mother, father, etc.)
1. Date of Passing
(English Date)
MM slash DD slash YYYY
1. After Sundown?
Yes
No
Uknown
2. Relationship to You
(Mother, father, etc.)
2. In Loving Memory of
(Full English Name)
2. Date of Passing
(English Date)
MM slash DD slash YYYY
2. After Sundown?
Yes
No
Uknown
3. In Loving Memory of
(Full English Name)
3. Relationship to You
(Mother, father, etc.)
3. Date of Passing
(English Date)
MM slash DD slash YYYY
3. After Sundown?
Yes
No
Uknown
SUMMARY AND PAYMENT
PREFERRED PAYMENT METHOD
(Required)
Credit Card
Check
TOTAL AMOUNT DUE
Price:
$0.00
FOR PAYMENT BY CHECK, please include "High Holidays 2023" on the note line and make your check payable to TEMPLE BETH TORAH. Please mail your check to:
TBT HIGH HOLIDAY COMMITTEE
PO BOX 2020
CENTREVILLE, VA 20122
To pay by credit card, please click
HERE
, enter the total amount due, and check the box to cover the fees (we appreciate it).
MAKE SURE TO CLICK SUBMIT ON THIS FORM AFTER COMPLETING PAYMENT
Δ
