Almost There! Date * MM DD YYYY Name * First Name Last Name Email * Phone * Country (###) ### #### Card Type * Visa Mastercard American Express Other: Card Number * Exp. Date (MM/YY) * CVV * Card Holder Name * Billing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How did you hear about us? * Friends Flyer Google Facebook WhatsApp Totally Jewish Travel Other: Authorization: I, Hereby authorize Chabad Outreach to charge my credit card listed above in the amount of: * Total Amount: $ Have You Made A Special Arrangement Default (Check This Box) Special Arrangement This charge is my payment for Rosh Hashanah 5786/2025 program fee as authorized by me, with Chabad Outreach at the Hawks Cay Resort in Duck Key Florida. The charge for Rosh Hashanah 5786/2025 program will show on statement as "Chabad Outreach" * By Signing My Name I Agree to the Above: Thank you! We Have all the information we need and look forward to accommodating you this coming Rosh Hashanah.
