Shabbat PM 9/16 + Dinner - Form

Shabbat PM dinner by Old Jerusalem at the Potrero Hill Neighborhood House

Registrant Information

* First Name

* Last Name

* Email for registration confirmation

* I would like to purchase dinner tickets for Shabbat Dinner with the Kitchen community

* Are you a member of The Kitchen?

Ticket Tiers

* How many adult dinner tickets do you want to purchase?

If purchasing tickets for more individuals than yourself, be sure to enter each registrants first & last name, and email address.

* How many adult dinner tickets do you want to purchase?

If purchasing tickets for more individuals than yourself, be sure to enter each registrants first & last name, and email address.

* How many adults are you registering to attend shabbat services?

If registering more individuals than yourself, be sure to enter each registrants first & last name, and email address.

Person 1: First Name

Person 1: Last Name

Person 1: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 1: First Name

Person 1: Last Name

Person 1: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 1: First Name

Person 1: Last Name

Person 1: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$36 - Thriving / professionally coasting—This tier covers your meal$26 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$38 - Thriving / professionally coasting—This tier covers your meal$28 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

Person 2: First Name

Person 2: Last Name

Person 2: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 2: First Name

Person 2: Last Name

Person 2: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 2: First Name

Person 2: Last Name

Person 2: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$36 - Thriving / professionally coasting — this tier covers your meal$26 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$38 - Thriving / professionally coasting — this tier covers your meal$28 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

Person 3: First Name

Person 3: Last Name

Person 3: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 3: First Name

Person 3: Last Name

Person 3: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 3: First Name

Person 3: Last Name

Person 3: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$36 - Thriving / professionally coasting — this tier covers your meal$26 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$38 - Thriving / professionally coasting — this tier covers your meal$28 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

Person 4: First Name

Person 4: Last Name

Person 4: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 4: First Name

Person 4: Last Name

Person 4: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 4: First Name

Person 4: Last Name

Person 4: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$36 - Thriving / professionally coasting — this tier covers your meal$26 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$38 - Thriving / professionally coasting — this tier covers your meal$28 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

Person 5: First Name

Person 5: Last Name

Person 5: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 5: First Name

Person 5: Last Name

Person 5: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

Person 5: First Name

Person 5: Last Name

Person 5: Email

I attest that I am fully vaccinated (and boosted, if applicable) against COVID-19. Type "YES" below to verify

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$36 - Thriving / professionally coasting — this tier covers your meal$26 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

* This wouldn't be a shabbat dinner without everyone, please choose the ticket tier that is appropriate for you

$38 - Thriving / professionally coasting — this tier covers your meal$28 - Are you a Starving Artist or Recent Grad? Either way, this is for you. We want you here!

How many child dinner tickets would you like to purchase?

We want our shabbat dinners to be inclusive for the entire community, including those who may have financial barriers. Please consider making a donation towards community dinner tickets, which will be used to ensure that everyone who wants to attend shabbat dinner can.

If you would like to make an additional gift, enter the amount below