Congregation Beth Hatikvah -- High Holidays Member Registration, 2010

A Reconstructionist Community in Summit, New Jersey

High Holiday On-Line Registration For CBH Members

Please provide the following information. Once you have submitted your form, you will not be able to make changes on-line but Andrea in our office will be glad to assist you; please contact her by phone at 908.277.0200 or by e-mail.

You can use the TAB key to advance to the next field in the form.

Family Information Adult Member 1 - First name: Last name: E-mail:

Adult Member 2 - First name: Last name: E-mail:

Street Address - 1: Telephone: () -

Street Address - 2:

City: State (if not NJ): Zip:

Children First name:    Last name:

First name:    Last name:

First name:    Last name:

First name:    Last name:

If you need to register more children, or if there are special needs, please provide this information in the Notes section below.

Guests First name:    Last name:
Please indicate if this guest is an adult or child -    Adult:    Child:

First name:    Last name:
Please indicate if this guest is an adult or child -    Adult:    Child:

First name:    Last name:
Please indicate if this guest is an adult or child -    Adult:    Child:

First name:    Last name:
Please indicate if this guest is an adult or child -    Adult:    Child:

If you need to register more guests, or if there are special needs, please provide this information in the Notes section below.

Attendance Information

Seat Request Number of adult seats (included with membership)

Children/teens/college students/military guests (included with membership)

Number of affiliate guest seats (i.e., affiliated with another congregation) @ $50 each

Number of unaffiliate guest seats (i.e., unaffiliated with another congregation) @ $75 each

Number of seats requested

$ Seat Charge (Subtotal)

High Holiday Services - Planned Attendance To help us plan better, please indicate your family's plan for attending our services and programs - please enter the number of family members expected for each event...

Erev Rosh Hashanah -
Wednesday, September 8
Service at 7:30pm

Rosh Hashanah, Day 1 -
Thursday, September 9
Main service at 9:30am

Family Service at 2:30pm

Rosh Hashanah, Day 2 -
Friday, September 10
Service at 9:30am

Kol Nidre -
Friday, September 17
Service at 7:00pm

Yom Kippur -
Saturday, September 18
Service at 9:30am

Family Service at 2:30pm

Minchah, Yizkor, Ne'ilah at 4:00pm

Break-the-Fast (Adults) at 6:30pm

Break-the-Fast (Children 3-12)

High Holiday Youth Programming - Planned Attendance The recommended donation is $30 per child for each day's program and the maximum requested donation is $180 per family.

Kindergarten age children can be registered either for babysitting or the youth programming at the parents' discretion.

Pre-school and Kindergarten-age children: Babysitting

The Youth Programs will be held from 9:30 - 12:00

Child's Name:      Age:      Special Diet or Needs:
Rosh Hashanah - Day 1:      Yom Kippur:

Child's Name:      Age:      Special Diet or Needs:
Rosh Hashanah - Day 1:      Yom Kippur:

Child's Name:      Age:      Special Diet or Needs:
Rosh Hashanah - Day 1:      Yom Kippur:

Grades K-7: Youth Program

Child's Name:      Grade:      Special Diet or Needs:
Rosh Hashanah - Day 1:      Yom Kippur:

Child's Name:      Grade:      Special Diet or Needs:
Rosh Hashanah - Day 1:      Yom Kippur:

Child's Name:      Grade:      Special Diet or Needs:
Rosh Hashanah - Day 1:      Yom Kippur:

  This is the total number of child-events you have selected.

Youth Programming Donation - For example, $30.00 per child per session with a family maximum of $180.

Notes If you need to register more than 4 children or guests, or if there are special needs that you want to tell us about, please provide this information here. (No need to repeat those already indicated in the Youth Programing section.)

Yizkor Memorial Booklet It is customary to honor loved ones who have passed away by having their names listed in a Yizkor Memorial booklet that is distributed on Yom Kippur.

In memory of: Enter the name of the deceased Relationship: For example - mother of Gayle Cohen

1. In memory of:    Relationship:

2. In memory of:    Relationship:

3. In memory of:    Relationship:

4. In memory of:    Relationship:

5. In memory of:    Relationship:

6. In memory of:    Relationship:

Yizkor donation - we suggest a donation of $18.00 for each person you are honoring. Thank you.

High Holiday Appeal Donation Help us build a wonderful new year by donating generously to our High Holiday appeal.

Select amounts from the pull-down menus to choose your donation:
Multiples of $100 + Multiples of $18
--------------------------------------------------------
$ Thank you!

Summary of Charges and Donations Here is the summary of charges and donations for your registration.

$  Seat Charge

$  Youth Programming Donation

$  Yizkor Donation

$  High Holiday Appeal Donation
--------------------------------------------------------
$  Total charges and donations

Please select payment type -- Credit Card (MasterCard, Visa, Discover):    Check:

Please click on the link to print a copy of your registration...
this will be your only opportunity: Print Registration Form

This will submit your registration. (If you are paying by credit card, the next screen will take you to the credit card processing page; if you are paying by check, the next screen will give you our mailing address.)

The 'reset' button will erase the form and you will have to start over.