Register for HABSTY 2022-2023

Register for HABSTY 2022-2023

Mondays

8:30 - 9:00 PM

@Holy Blossom Temple

Members: $18

Non-Members: $36

Registration Information

Parent First Name

Parent Last Name

Why are we asking for pronouns? https://urj.org/quick-guide-pronouns

Parent Email Address

Are you a member at Holy Blossom Temple?

YesNo

Are you affiliated with another congregation?

YesNo

Congregation Name

Please send me information about membership at Holy Blossom Temple

Please subscribe me to Holy Blossom's bi-monthly newsletter, "On the Horizon," for upcoming programs & events

Student Information

Pronouns

Please specify

Student First Name

Student Last Name

Grade

Phone number

Student Email Address

Fee & Payment

Total Fee

Credit Card Information

First Name

Last Name

Billing Address

Billing City

Billing Province

Billing Postal Code

Billing address must match the address associated with the credit card.

Credit Card Number

Visa or Mastercard

Expiry Month

Expiry Year

Yes! I would like to make a contribution to future programming at Holy Blossom Temple

Thank you! You will now be redirected to the Holy Blossom Temple website after registering. Please check your email for additional information.

Thank you! You will now be redirected to program donation form. Please check your email for confirmation of your registration.

Invoice Name

Authnet_Hidden_Fields

Final Contribution

Invoice req'd

YesNo

Contact Information