Registration Form Last Name First Name Age School Grade Address City State Zip Phone number Email address Please indicate witch trip you would like to join. December 14 February 1 March 22 May 3 $15 per membership. Cost per a trip: December 14th, February 1st, and March 22nd. Members $8, Non Members $10 May 3rd, Members $12, Non Members $15 Payment: Visa Master Card Discover Total amount Card Number January February March April May June July August September October November December 2008 2009 2010 2011 2012 2013 Expiration Date Security: The Lubavitch Center uses technology that encrypts all information from the end-user to the web server. This is known as SSL encryption. In fact we use the highest form of this encryption, 128 bit SSL encryption. Secure pages are identified by the "lock" icon in your browser and by the web address beginning with "https://" I will be paying at the door Membership ($15) Trip ( Members $8 Non Members $10 - May 3rd Members $12 Non Members $15) Questions or comments For information please contact us at 215 497 9925 Ext.13 or email [email protected] This page uses 128 bit SSL encryption to keep your data secure.
