Yomim Noraim Seat Request Form - Form - Kehilas Bais Yisroel, the MB Glassman Synagogue

ALL FORMS AND PAYMENTS MUST BE RECEIVED BY TUESDAY SEPTEMBER 16.

* First Name

* Last Name

* Email

* Phone Number

SEATS

In order to receive Member/Associate Member prices, your account must be in good standing through the month of August 2025. For questions regarding membership and/or account status, please email office@baisyisroel.com.

Please Note: Pricing is the same regardless of how many days you attend

* Please indicate your membership status

Please Select OneFull MemberAssociate MemberNon Member/Guest

Full Members:

Seats in the Men's Section -$0

Seats in the Women's Section - $0

Associate Members:

Non-Members/Guests:

Seats Notes/Comments: (If you don't plan to attend all three days please let us know!)

CHILDCARE

Will you be enrolling children in childcare?

NOYES

ROSH HASHANA (BOTH DAYS) & YOM KIPPUR -
CHILDCARE WILL BE AT THE SIROTA HOME,
NEXT DOOR TO THE SHUL.

Childcare will be available during Shofar blowing and Mussaf
(starting at 10:30am on Rosh Hashanah; and 11:00am on Yom Kippur).

The cost is $20 per child per day/$65 maximum per family PER DAY.
Registration and payment must be received by Tuesday September 16, 2025.
Children who will be in childcare at any time (even if they have a seat) must be registered for childcare.
All children MUST have a parent or guardian IN SHUL while they attend childcare.

ENTER CHILDCARE INFORMATION

Child's Name

Age

RH Day 1

RH Day 2

Child's Name

Age

RH Day 1

RH Day 2

Child's Name

Age

RH Day 1

RH Day 2

Child's Name

Age

RH Day 1

RH Day 2

Child's Name

Age

RH Day 1

RH Day 2

CHILDCARE PAYMENT
(YOU MUST COMPLETE THIS SECTION
REGARDLESS OF MEMBERSHIP STATUS)

Childcare Notes/Comments:

Total: (Seats+Childcare)