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Congregational Bingo Night 7/14/22
Please verify reCaptcha before submitting the form.
Bingo
Bash
(All Ages)
Number Adults Registering
1
2
3
4
Number Children Registering
None
1
2
3
4
*
First Name
*
Last Name
*
Email
Cell Phone
First Name
Last Name
Email
Cell Phone
First Name
Last Name
Email
Cell Phone
First Name
Last Name
Email
Cell Phone
Child(ren)
Child 1 First Name
Child1 Last Name
Child 1 Food Allergies
Gluten
Dairy
Peanuts/Tree Nuts
Other
Check All That Apply
Other Food Allergies
Child 2 First Name
Child 2 Last Name
Child 2 Food Allergies
Gluten
Dairy
Peanuts/Tree Nuts
Other
Check All That Apply
Other Food Allergies
Child 3 First Name
Child 3 Last Name
Child 3 Food Allergies
Gluten
Dairy
Peanuts/Tree Nuts
Other
Check All That Apply
Other Food Allergies
Child 4 First Name
Child 4 Last Name
Child 4 Food Allergies
Gluten
Dairy
Peanuts/Tree Nuts
Other
Check All That Apply
Other Food Allergies
Masks Required Inside
Optional Outside
Wed, January 15 2025 15 Tevet 5785
