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Bar or Bat Mitzvah Date Reservation Request

Thank you for choosing to celebrate your simcha at Chabad!

Please use this form to request the date for your simcha. We do not reserve more than one bar or bat mitzvah on any date, but there may occasionally be other simchas that week (bris, baby naming, aufruf) that may need to be held on the same Shabbos.

We will send a form with kiddush and event specifics closer to the date of your simcha.

Please note that bar and bat mitzvah reservations are available for Chabad shul members.
Parent Full Name*

First Name Last Name
E-mail*
Phone Number*

Area Code Phone Number

Address

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

Name of Bar or Bat Mitzvah*
Date of Simcha*

Month Day Year
Parsha for that Week*
Payment Information
Tax-deductible Bar/Bat Mitzvah Fee*

$300
Total

$0.00

Payment*

Credit Card Check

Postal / Zip Code

Country

Should be Empty:

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