Full Name* First Name Last Name E-mail* Phone Number* Area Code Phone Number Please list all family members who are coming. WELCOME TO LAG BAOMER 2021! ENJOY AN EVENING OF STORY AND SONG WITH DANIEL GIL - entertainment for adults though kids may stay if they wish as well as a PETTING ZOO earlier for kids to enjoy! FREE ADMISSION FOR ENTERTAINMENT AND FUN! If you are ordering food, reservation must be in by April 28. All orders will be individually wrapped. It helps us to know if you are coming - so please RSVP whether ordering food or not. You are welcome to join us for any part of the evening or the whole thing. SPOSORSHIP Thank you to Gary and Natalie Waleik for generously coming forward to help sponsor the entertainment for this event. We will add to this list anyone who contributes $200 or more towards the expenses. Of course a donation of any amount will be appreciated and is a mitzvah! Everyone is welcome to join and enjoy the fun and entertainment at no charge. (Smores and drinks also complimentary.) There is only a cost for the boxed dinner if you choose. See details below. BOXED BBQ DETAILS - Please make sure orders are submitted by April 28. $5 per hot dog $8 per burger (Limited quantity of vegetarian available - must specify if requesting) Each individually packaged dinner comes with (a bun and) 2 sides you can choose out of these 3 options: Corn on cob, Cole slaw or Potato Salad Please use comments box below to clearly write up your order(s). Payment Credit Card Other Credit Card Visa MasterCard American Express Discover 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 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 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 Please fill in the amount that applies according to above list. Donations may be added here if you wish. $ Total $0.00 Please use this comment box to add any details about your order . I would like to receive news and updates by email Submit Should be Empty: This page uses TLS encryption to keep your data secure.