Pesach in Hawaii 2022 Program Questionnaire

PLEASE FILL OUT ALL THE FIELDS BELOW. If any field is not applicable (but required by the form), just fill in NONE or N/A.

All the information below is needed in order to give you the most wonderful experience at Pesach in Hawaii! PLEASE FILL IN THIS QUESTIONNAIRE before Wed. April 6.

Many thanks and we look forward to meeting you and getting to know you in person very soon!

Full Name*

First Name Last Name

Phone Number*

Area Code Phone Number

E-mail*

Address*

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

Spouse / Companion Name*

First Name Last Name

Spouse / Companion E-mail*

Spouse / Companion Phone Number*

Area Code Phone Number

Are you part of a larger extended family group?* IMPORTANT for meals seating

Yes No

If yes, please tell us the name of your extended family /families/ / group*

# of Children*

Child #1

First Name Last Name

Child #1 age

Child #2

First Name Last Name

Child #2 age

Child #3

First Name Last Name

Child #3 age

Child #4

First Name Last Name

Child #4 age

Child #5

First Name Last Name

Child #5 age

Child #6

First Name Last Name

Child #6 age

Do you require a high-chair?*

Yes No

Will your Children be attending Day Camp? (4/16, 4/17, 4/22, 4/23; 9:30 am - 12:30 pm; 2:00 pm - 5:00 pm)*

Yes No

Please indicate names (& ages) of children attending Day Camp*

Arrival Date & Time in Hawaii

Month Day Year

at Hour Minutes

DO YOU/ ANY FAMILY MEMBERS HAVE ANY ALLERGIES? PLEASE DETAIL RELEVANT INFO

Do you want your kitchen in your Trump Hotel room Kashered / kosherized? ($250 fee )*

Yes No

CLICK ONE OF FIRST 3 OPTIONS IN THE QUESTION BELOW ONLY IF YOU HAVE ALREADY PRE-ARRANGED having Seder/s in your room with Rabbi Itchel. ($360 per Seder).

If you haven't made any previous arrangements for in-room Seders, please choose the last option.

(One option must be chosen.)

SEDERS: CHOOSE ONE*

In-room Seder #1 only In-room Seder #2 only In-room Both Seders 1 & 2 We will be eating together with the program, with Pesach in Hawaii participants..

How many adults and how many children will be participating in your in-room Seder?*

Would you like to have a waiter in your room, assisting during your Seder? ($150 fee for 3 hour service)

Yes, we would like a waiter to assist No need for a waiter; we will handle it ourselves

Total

$0.00

Payment

Credit Card

Credit Card Type
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

I would like to receive news and updates by email

Pesach in Hawaii 2022 Program Questionnaire

Family Information (Please include everyone - (ie children of any age) in your immediate family group, including babies of any age.)

Other Important Information