Purim Registration 2018

I would like to register for The Song Shul's Musical Interactive Megillah!

Name* (adult #1)

Phone number*

Email address*

Name (adult #2)

Name (adult #3)

Name (adult #4)

Children under 12 (FREE)

How many tickets would you like?

Regular (age 12+)

$10 X

Children (under 12)

$0 X

Children's entry is free!

Partner with us and be a Royal Sponsor!

King

$1,000

Shushan Mayor

$500

Chamberlain

$360

TOTAL

Payment Method*

I will send a PayPal paymentI will send an e-transfer to info@songshul.com (please send secondary email with security answer)Phone me for credit card infoCharge my credit card below:VisaMasterCardAmEx

Card number

Expiry date

Security code

Name exactly as it appears on the credit card

Signature

Date

I am paying by credit card and I authorize The Song Shul to charge my credit card. (3% will be added to credit card payments)

If paying by credit card:

Street Address

Apt number

City

Province/state

Postal code

Signature of Adult #1*

Date*

*required field

Rethink Shul.

Purim Registration 2018

I would like to register for The Song Shul's Musical Interactive Megillah!