Lion Country Safari

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Bais Menachem Chol Hamoed Trip Lion Country Safari, Monday - 19th of Nissan, April 6th
Full Name*
First Name Last Name
Phone Number*

Area Code Phone Number
E-mail*
How many will be joining in the following age groups
Ages 0-2 (free)
Ages 3-17 Bais Menachem Member ($14 per child)
Ages 3-17 Non - Bais Menachem Member ($20 per child)
Age 18 & older - Bais Menachem member ($18- per adult )
Age 18 & older - non - Bais Menachem member ($25 - per adult )
Once form is submitted you will receive a confirmation email with group entry information.
Please note, Bais Menachem reserves the right, that if the form is filled out incorrectly to charge the customer the correct amount.
Total

$0.00

Payment

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We accept Visa, MasterCard, American Express, Discover
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Name on Card
Expiration Month	Expiration Year

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Bais Menachem Chol Hamoed Trip Lion Country Safari, Monday - 19th of Nissan, April 6th