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			<h1 class="article-header__title js-article-title js-page-title">Shofar in the Park RSVP</h1>
		
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<form class="userform-form" action="" method="post" name="form_5214805" id="5214805" accept-charset="utf-8"><input type="hidden" name="formID" value="5214805" /><div class="form-all dir_ltr" dir="ltr"><ul class="form-section"><li class="form-line" id="id_51"><div id="cid_51" class="form-input-wide"> <div style="text-align:center;"><img alt="" class="form-image" border="0" src="https://w2.chabad.org/media/images/1331/cRuJ13319674.png" height="539" width="963" /></div> </div></li><li class="form-line" id="id_35"><div id="cid_35" class="form-input-wide"> <div id="text_35" class="form-html"><p>Men, women, and children are invited to join us for a mystical Rosh Hashanah service!<br />
Experience Shofar blowing, classic Rosh Hashanah melodies, heartfelt prayers all set against the serene and beautiful backdrop of the park.</p>

<p>Don’t miss this uplifting and family-friendly outdoor gathering!</p>

<p>Tuesday, September 23 | 5:30 PM </p>

<p>Location: Crestmoor Park Picnic area </p>

<p>- Rosh Hashana refreshments to follow the service. </p>

<p>- Your seat will be reserved for you under the name you list here. </p>
</div> </div></li><li class="form-line" id="id_9"><div class="form-label-left" id="label_9"><label for="input_9"> Full Name<span class="form-required">*</span> </label><label class="label-message" for="input_9"> </label></div><div id="cid_9" class="form-input"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q9_fullName9[first]" id="first_9" autocomplete="given-name" />  <label class="form-sub-label" for="first_9" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q9_fullName9[last]" id="last_9" autocomplete="family-name" />  <label class="form-sub-label" for="last_9" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_10"><div class="form-label-left" id="label_10"><label for="input_10"> E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_10"> </label></div><div id="cid_10" class="form-input"> <input type="email" class=" form-textbox validate[required, Email]" id="input_10" name="q10_email10" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_12"><div class="form-label-left" id="label_12"><label for="input_12"> Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_12"> </label></div><div id="cid_12" class="form-input"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q12_phoneNumber12[area]" id="input_12_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_12_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q12_phoneNumber12[phone]" id="input_12_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_12_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_46"><div id="cid_46" class="form-input-wide"> <div id="text_46" class="form-html"><p>You can choose a complimentary seat or a reserved seat which would have a suggested subsidized donation of $36 per seat to help off set the costs of this event.</p></div> </div></li><li class="form-line" id="id_47"><div class="form-label-left" id="label_47"><label for="input_47"> Which prayer book would you like at your seat?<span class="form-required">*</span> </label><label class="label-message" for="input_47"> </label></div><div id="cid_47" class="form-input"> <div class="form-single-column"><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_47_0" name="q47_input47[]" value="Hebrew with English Translation" /><label id="label_input_47_0" for="input_47_0"><span>Hebrew with English Translation</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_47_1" name="q47_input47[]" value="Hebrew With Russian Translation" /><label id="label_input_47_1" for="input_47_1"><span>Hebrew With Russian Translation</span></label></span><span class="clearfix"></span><span class="form-checkbox-item clear-left"><input type="checkbox" class="form-checkbox validate[required]" id="input_47_2" name="q47_input47[]" value="I'll bring my own" /><label id="label_input_47_2" for="input_47_2"><span>I'll bring my own</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_28"><div class="form-label-left" id="label_28"><label for="input_28"> Woman premier Seating $36 </label><label class="label-message" for="input_28"> </label></div><div id="cid_28" class="form-input"> <input type="number" class="form-number-input  form-textbox" id="input_28" name="q28_adults28" style="width:60px" size="5" value="" data-type="input-number" autocomplete="nope" min="0" data-numbermin="0" /> </div></li><li class="form-line" id="id_48"><div class="form-label-left" id="label_48"><label for="input_48"> Woman complimentary seat  </label><label class="label-message" for="input_48"> Donation options below if you'd be so inclined </label></div><div id="cid_48" class="form-input"> <input type="number" class="form-number-input  form-textbox" id="input_48" name="q48_adults48" style="width:60px" size="5" value="" data-type="input-number" autocomplete="nope" min="0" data-numbermin="0" /> </div></li><li class="form-line" id="id_38"><div class="form-label-left" id="label_38"><label for="input_38"> Men premier Seating $36 </label><label class="label-message" for="input_38"> </label></div><div id="cid_38" class="form-input"> <input type="number" class="form-number-input  form-textbox" id="input_38" name="q38_adults38" style="width:60px" size="5" value="" data-type="input-number" autocomplete="nope" min="0" data-numbermin="0" /> </div></li><li class="form-line" id="id_49"><div class="form-label-left" id="label_49"><label for="input_49"> Men complimentary seat </label><label class="label-message" for="input_49"> Donation options below if you'd be so inclined </label></div><div id="cid_49" class="form-input"> <input type="number" class="form-number-input  form-textbox" id="input_49" name="q49_adults49" style="width:60px" size="5" value="" data-type="input-number" autocomplete="nope" min="0" data-numbermin="0" /> </div></li><li class="form-line" id="id_37"><div class="form-label-left" id="label_37"><label for="input_37"> Number of Children (under age 12) Attending: (Free) </label><label class="label-message" for="input_37"> </label></div><div id="cid_37" class="form-input"> <input type="number" class="form-number-input  form-textbox" id="input_37" name="q37_children37" style="width:60px" size="5" value="" data-type="input-number" autocomplete="nope" min="0" data-numbermin="0" /> </div></li><li class="form-line" id="id_44"><div class="form-label-left" id="label_44"><label for="input_44"> Last name to be listed on the seats of this reservation ? </label><label class="label-message" for="input_44"> </label></div><div id="cid_44" class="form-input"> <input type="text" class=" form-textbox" data-type="input-textbox" id="input_44" name="q44_input44" size="20" value="" /> </div></li><li id="cid_43" class="form-input-wide"> <div class="form-header-group"><h2 id="header_43" class="form-header">Optional Contribution</h2></div> </li><li class="form-line" id="id_42"><div id="cid_42" class="form-input-wide"> <div id="text_42" class="form-html"><p><strong><em>Opening the Gates of Heaven by Opening our </em></strong><strong><em>Hearts</em></strong></p>

<p><em>Please</em><em> consider a tax deductible donation to help cover the costs of these and other wonderful and vital programs that our Jewish Center brings to our community. Thank you for making a difference for the community! </em></p>
</div> </div></li><li class="form-line" id="id_40"><div class="form-label-left" id="label_40"><label for="input_40"> Yes, I would love to help sponsor the holidays with a tax deductible gift of my choice </label><label class="label-message" for="input_40"> </label></div><div id="cid_40" class="form-input"> <div class="form-multiple-column" data-columns="3"><span class="form-radio-item"><input type="radio" class="form-radio" id="input_40_0" name="q40_input40" value="18" /><label for="input_40_0"><span>$18</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_40_1" name="q40_input40" value="54" /><label for="input_40_1"><span>$54</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_40_2" name="q40_input40" value="180" /><label for="input_40_2"><span>$180</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_40_3" name="q40_input40" value="360" /><label for="input_40_3"><span>$360</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_40_4" name="q40_input40" value="540" /><label for="input_40_4"><span>$540</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_40_5" name="q40_input40" value="720" /><label for="input_40_5"><span>$720</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio" id="input_40_6" name="q40_input40" value="1800" /><label for="input_40_6"><span>$1800</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_40_7" name="q40_input40" value="3600" /><label for="input_40_7"><span>$3600</span></label></span><span class="clearfix"></span><span class="form-radio-item"><input type="radio" class="form-radio" id="input_40_8" name="q40_input40" value="5000" /><label for="input_40_8"><span>$5000</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_39"><div class="form-label-left" id="label_39"><label for="input_39"> Total </label></div><div id="cid_39" class="form-input"> <div id="total_amount">$0.00 </div><div class="form-single-column form-checkbox-item" id="div_offset_gift_39" style="padding-top: 10px">           <input type="checkbox" id="input_39" class="form-checkbox" name="q39_offsetGiftPercent" value="3" />            <label id="label_39" for="input_39">Yes, I'd like to donate the cost of processing this transaction by adding 3%</label>                <input type="hidden" id="hidden_39" name="q39_offsetGiftAmount" />              <div class="clearfix"></div>            </div> </div></li><li class="form-line" id="id_45"><div class="form-label-left" id="label_45"><label for="input_45"> Payment </label><label class="label-message" for="input_45"> </label></div><div id="cid_45" class="form-input"> <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2" class="form-payment-methods form-multiple-column"></td></tr><tr class="paypal "><td colspan="2">Paypal has been selected. Payment will take place on the next page.</td></tr></tbody></table> </div></li><li class="form-line" id="id_2"><div id="cid_2" class="form-input-wide"> <div style="text-align: center; text-indent:156px;" class="form-buttons-wrapper button-align-auto"><button id="input_2" type="submit" class="form-submit-button  form-submit-button-none;">Submit</button></div> </div></li><li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li></ul></div><input type="hidden" id="simple_spc" name="simple_spc" value="5214805" /><script type="text/javascript">document.getElementById("si"+"mple"+"_spc").value = "5214805-5214805";</script></form></div>
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