Printed fromChabadWestHempstead.org

Annual Women's Spa Day

Indulge, relax, and rejuvenate with us!

ב"ה

Spa Day RSVP

Reservation and Registration Page
Personal Information
Full Name*

First Name Last Name
Phone Number*
E-mail*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Journal Ad
Do you want to put an ad in the journal?

Yes (entrance fee is waived)No
Ads All ads include 1 entrance fee

$500 Diamond Full Page - includes entrance and 15 raffle tickets$360 Gold Full Page - includes entrance and 10 raffle tickets$250 Silver Full Page - includes entrance and 7 raffle tickets$180 Full Page Ad - includes entrance and 5 raffle tickets$100 1/2 Page Ad - includes entrance and 2 raffle tickets$50 1/4 page ad - includes entrance
Please forward ads to [email protected]
(Note: This email is ONLY for ad submission)
Who's Attending
Who's Coming?* Babies under 5 no charge ( must be accompanied by adult)

$50 at the door$18 Teen Girls$5 Girls 5-12
Who's Coming?* Babies under 5 must be accompanied by adult

AdultsTeen GirlsGirls Ages 5-12
How many adults?*
How many adults?*
How many teens (13+)*
How many girls?*
How many adults?*
Adult 1*

First Name Last Name
Adult 1 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Adult 2*

First Name Last Name
Adult 2 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Adult 3*

First Name Last Name
Adult 3 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Adult 4*

First Name Last Name
Adult 4 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Adult 5*

First Name Last Name
Adult 5 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Teen 1*

First Name Last Name
Teen 1 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Teen 2*

First Name Last Name
Teen 2 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Teen 3*

First Name Last Name
Teen 3 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Teen 4*

First Name Last Name
Teen 4 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Teen 5*

First Name Last Name
Teen 5 Add Ons

$10 Paint Night with Rena Maryles$10 Tying Tzitzit for Soldiers with Esti Rubin$30 15 min Massage with Shifra Gutlove Levy
Child 1*

First Name Last Name
Child 2 *

First Name Last Name
Child 3*

First Name Last Name
Child 4*

First Name Last Name
Child 5*

First Name Last Name
Raffle Tickets
How many Raffle Tickets do you want?

1 Ticket - $5
Purchase raffle tickets in packs of 3 and save!

3 Tickets - $10
Must pay in advance and sign-up your time on spreadsheet- Please fill in the spreadsheet for time
Full Name

First Name Last Name
Phone Number
E-mail
Full Name

First Name Last Name
Phone Number
E-mail
Full Name

First Name Last Name
Phone Number
E-mail
Payment
Total

$0.00

Payment*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

I would like to receive news and updates by email
Should be Empty:

This page uses TLS encryption to keep your data secure.

UPDATES

Registration Deadline

Price Jumps on June 27

Upcoming Events

There are no events posted at this time. Please contact us for more info about our events.