Youth House - SIX Broadway Show - Form - Temple Israel of Great Neck

Youth House - SIX Broadway Show

SIX Broadway Show

Please join the Waxman H. S. & Youth House to see:
SIX the Musical
47th Street & Broadway
Thursday, January 9
We will meet at the Great Neck train station at 5:30pm.
Show starts at 7:00pm.

Please fill out form below. There are a limited amount of seats.

* Teen First Name

* Teen Last Name

Teen Email Address

* Teen Cell Phone

* Graduation Year

* Please enter 1 to save your seat.

Ticket - $130.00 - 12 OpenThis does not include the cost of the train.

* Dietary restrictions

Are you a member of Temple Israel and/or Youth House participant?

* Parent First Name

* Parent Last Name

* Parent Email Address

* Parent Cell Phone

Parent First Name

Parent Last Name

Parent Email

Parent Cell Phone

* I agree to the following:

I agree to the following:

I give permission for my teen to participate in Temple Israel's Waxman Youth House's Broadway show trip. We will take the train and subway to the theater.
I give Temple Israel permission to use photos of my teen in its publicity such as in the Voice, on the TIGN website, in local newspapers, etc.
I have explained the behavioral expectations of participation in this event to my teen.

Emergency Information

* Allergies or other important medical information

Do NOT list parent(s) as alternative emergency contacts.

* Emergency Contact

* Emergency Phone

Emergency Contact

Emergency Phone

Total Amount

Sat, December 21 2024 20 Kislev 5785

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