Woodbridge Jewish Russian Community Annual Picnic - Jewish Russian Community Centre of Ontario

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Woodbridge Jewish Russian Community Annual Picnic - Jewish Russian Community Centre of Ontario

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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

Number of Adults attending the BBQ*
Number of Childrin attending the BBQ Age 10 and under
I would like to donate:

$25.00$50.00$100.00$180.00$500.00$1800.00

Payment

Credit Card

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

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