Below is a form to signup for the Quiz Night Full Name* First Name Last Name E-mail* Choose 1 of the following choices:* Pay/Reserve a Seat (£30 per seat)Reserve a table (table of 10 people - £300, free seat)Sponsor an AD on a table (£20 per table for advertisment) How many seats are you reserving/paying??* 1 Seat2 Seats3 Seats4 Seats5 Seats6 Seats7 Seats8 Seats9 Seats10 Seats Full Name of Seat 1 First Name Last Name Full Name of Seat 2 First Name Last Name Full Name of Seat 3 First Name Last Name Full Name of Seat 4 First Name Last Name Full Name of Seat 5 First Name Last Name Full Name of Seat 6 First Name Last Name Full Name of Seat 7 First Name Last Name Full Name of Seat 8 First Name Last Name Full Name of Seat 9 First Name Last Name Full Name of Seat 10 First Name Last Name Please provide name of whose table your reserving a seat with:* write none if not applicable How many ADs are you sponsoring?* 1 table2 tables3 tables4 tables5 tables Any comments for us: Pay In Advance:* Select an option Credit Card Paypal Other Credit Card We accept Visa, MasterCard, American Express, Discover Credit Card Number Security Code Name on Card1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Expiration Month2026202720282029203020312032203320342035 Expiration YearPaypal has been selected. Payment will take place on the next page.Price At The Door is £35 per seat Total £0.00 GBP Yes, I'd like to donate the cost of processing this transaction by adding 1.4% I would like to receive news and updates from Chabad Lubavitch of Bricket Wood & Districts by email. I understand that information I provide to Chabad Lubavitch of Bricket Wood & Districts will be used according to its Privacy Policy and I can unsubscribe at any time. Submit Should be Empty: This page uses TLS encryption to keep your data secure.