For security and organization purposes, please register for services and programs by September 19th. 1. Your Information Full Name* First Name Last Name Address* Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Phone Number* Area Code Phone Number E-mail* _____________________________________________________________________ Next Section Registration 2. Registration Number of Adults Attending* Number of Children( Ages 2-12) Attending* Name Of Adult 1 First Name Last Name Adult 1 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Kol Nidrei + Evening Services: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm Name Of Adult 2 First Name Last Name Adult 2 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Mincha Eve of Yom Kippur: 3:15 - 3:45 pm Kol Nidrei + Evening Services: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm Name Of Adult 3 First Name Last Name Adult 3 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Mincha Eve of Yom Kippur: 3:15 - 3:45 pm Kol Nidrei + Evening Services: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm Name Of Adult 4 First Name Last Name Adult 4 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Mincha Eve of Yom Kippur: 3:15 - 3:45 pm Kol Nidrei + Evening Services: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm Name Of Adult 5 First Name Last Name Adult 5 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Mincha Eve of Yom Kippur: 3:15 - 3:45 pm Kol Nidrei + Evening Services: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm Name Of Child 1 First Name Last Name Age of Child 1 Child 1 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Mincha Eve of Yom Kippur: 3:15 - 3:45 pm Kol Nidrei + Evening Services: 6:30 pm CKIDS! Children's Program: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm CKIDS! Children's Program: 10:30 am - 1:00 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm CKIDS! Children's Program: 6:30 pm - 8:00 pm Name Of Child 2 First Name Last Name Age of Child 2 Child 2 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Mincha Eve of Yom Kippur: 3:15 - 3:45 pm Kol Nidrei + Evening Services: 6:30 pm CKIDS! Children's Program: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm CKIDS! Children's Program: 10:30 am - 1:00 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm CKIDS! Children's Program: 6:30 pm - 8:00 pm Name Of Child 3 First Name Last Name Age of Child 3 Child 3 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Mincha Eve of Yom Kippur: 3:15 - 3:45 pm Kol Nidrei + Evening Services: 6:30 pm CKIDS! Children's Program: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm CKIDS! Children's Program: 10:30 am - 1:00 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm CKIDS! Children's Program: 6:30 pm - 8:00 pm Name Of Child 4 First Name Last Name Age of Child 4 Child 4 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Mincha Eve of Yom Kippur: 3:15 - 3:45 pm Kol Nidrei + Evening Services: 6:30 pm CKIDS! Children's Program: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm CKIDS! Children's Program: 10:30 am - 1:00 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm CKIDS! Children's Program: 6:30 pm - 8:00 pm Name Of Child 5 First Name Last Name Age of Child 5 Child 5 Will Attend Please only check the boxes that you COMMIT to attending! Rosh Hashana Yom Kippur Rosh Hashana Eve: (Sunday, September 25) Evening services: 6:00 - 7:15 pm Rosh Hashana 1st Day: (Monday September 26) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Shofar @ the Playground: 5:00 - 5:30 pm Mincha + Tashlich: 6:00 - 7:00 pm 2nd Shofar Blowing: 7:00 pm Evening services: 8:00 - 8:30 pm Rosh Hashana 2nd Day: (Tuesday September 27) Morning Services: 9:30 am - 1:00 pm CKIDS! Children's Program: 10:30 am - 12:30 pm Shofar Blowing: 11:30 am - 12:00 pm Mincha: 6:00 - 6:15 pm 2nd Shofar Blowing: 6:15 pm Chassidic Farbrengen: 6:30 Evening Services + Havdalah: 8:12 - 8:30 pm Yom Kippur Eve: (Tuesday October 4) Mincha Eve of Yom Kippur: 3:15 - 3:45 pm Kol Nidrei + Evening Services: 6:30 pm CKIDS! Children's Program: 6:30 pm Yom Kippur Day: (Wednesday October 5) Morning Full Services: 9:30 am - 2:30 pm CKIDS! Children's Program: 10:30 am - 1:00 pm Yizkor (Memorial Services): 11:45 am - 12:15 pm Mincha Services: 5:30 - 6:30 pm Ne'ila + Shofar: 6:30 - 7:54 pm CKIDS! Children's Program: 6:30 pm - 8:00 pm _____________________________________________________________________ Next Section Donations and Payment 3. Donations and Payment Donations - Select all that apply* The Total Suggested Donation is $1,500 includes support for services and outreach programs over the High Holidays. Suggested High Holiday Pledge - $1,100 Outreach to the Needy - $100 High Holiday Children's Programs - $100 High Holiday JLI - Adult Ed. Classes - $100 Jail & Hospital Visitation Programs - $100 *If you cannot afford these suggested amounts please consider a donation that fits your budget. Monthly donation plans are welcome. Total Pledge $0.00 Payment Options* Credit Card Cheque/E-Transfer Payment Frequency* One-time payment Monthly payments Monthly Payment Frequency Number of Monthly Payments I agree that my Total Pledge indicated above will be processed in equal installments split over the number of months selected. Cheques are to be made payable to Chabad Lubavitch of Alberta eTransfer: [email protected] Payment Credit Card Visa MasterCard American Express Credit Card Type Credit Card Number Security Code Name on Card 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Expiration Month 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 Expiration Year Billing Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Comments Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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