Creating a growing and dynamic community is a partnership and collective effort. Your membership and support over the past years is greatly valued and appreciated. Our partnership is even more critical as we move forward in these challenging yet exciting times. There are many benefits to being a member, including discounts and special gifts throughout the year, but the greatest benefit is the feeling of being a partner in a unique and warm community, with 2 convenient locations for services, that will serve as a spiritual home for you and your children to experience authentic Judaism in the most enjoyable and rewarding way. Please fill out this membership form and please consider an increase in your membership level for the coming year, as your circumstances allow. Thank you so much for your support and partnership. I'd like to* Become a memberRenew my membership Your Information Full Name* First Name Last Name Cell* Area Code Phone Number Email* Update Your Information Optional Check here to update your information if there have been changes since last year. Hebrew Name Father's Hebrew Name Mother's Hebrew Name Gender* MaleFemale Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Approx. time of birth Occupation Home Area Code Phone Number Work Area Code Phone Number Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Birth Mother Jewish by BirthConverted Did you convert? NoYes For male members KohenLeviteIsraelite Marital Status* MarriedSeparatedDivorcedWidowed Date of Marriage* Month Day Year Spouse Information Update Spouse Information Optional Check here to update your information if there have been changes since last year. Full Name* First Name Last Name Hebrew Name Father's Hebrew Name Mother's Hebrew Name Gender* MaleFemale Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year Approx. time of birth Occupation Home Area Code Phone Number Work Area Code Phone Number Cell Area Code Phone Number Email* Birth Mother Jewish by BirthConverted Converted? NoYes For male members KohenLeviteIsraelite Children's Information Update Children's Information Optional Check here to update your information if there have been changes since last year. No. of Children Name of Child #1 Hebrew Name Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year School Name of Child #2 Hebrew Name Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year School Name of Child #3 Hebrew Name Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year School Name of Child #4 Hebrew Name Birth Date 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year School Yahrtzeit Information Update Yahrtzeit Information Optional Check here to update your information if there have been changes since last year. No. of Yahrtzeits Hebrew Name #1* Father's Hebrew Name* English Name* First Name Last Name Relation* Date of Passing* and approx. time Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM Hebrew Name #2* Father's Hebrew Name* English Name* First Name Last Name Relation* Date of Passing* and approx. time Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM Hebrew Name #3* Father's Hebrew Name* English Name* First Name Last Name Relation* Date of Passing* and approx. time Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM Hebrew Name #4* Father's Hebrew Name* English Name* First Name Last Name Relation* Date of Passing* and approx. time Month Day Year at 123456789101112 Hour001020304050 MinutesAMPM I am interested in participating in the following areas Synagogue ServicesHoliday CelebrationsGan Israel Summer Day CampJunior CongregationSeniors ClubAdult Education ClassesTeen ProgrammingMen's ClubWomen's ProgramsPreschool of the ArtsMikvah for LadiesSunday Hebrew SchoolFriendship Circle ProgramVolunteeringLunch and Learn Membership Options Chabad of Parkland Membership 5787 Membership Year: Rosh Hashanah 5787 (September 12, 2026) – Erev Rosh Hashanah 5788 (October 1, 2027) We are deeply grateful for your partnership in strengthening Jewish life in our community. Your membership helps support our synagogue, educational programs, security, and the many services Chabad provides throughout the year. All membership levels include High Holiday seating and member discounts on community programs and events. Gold Membership and above also include one sponsored Kiddush during the year and preferred seating at community events. Legacy Visionary – $54,000 Includes: Shul Security Prominent recognition plaque in the synagogue lobby 6 High Holiday seats for adults Two Deluxe Kiddush Sponsorships High Holiday Honor – Aliyah Private trip for two to New York with the Rabbi for a visit to the Rebbe's Ohel Private dinner with the Rabbi and Rebbetzin Invitation to the exclusive Annual Leadership Vision Dinner Reserved VIP seating at all major community events Visionary of the Community – $36,000 Includes: Shul Security Recognition plaque in the synagogue lobby 4 High Holiday seats for adults One Deluxe Kiddush Sponsorship High Holiday Honor – Aliyah Trip for two to New York with the Rabbi for a visit to the Rebbe's Ohel Invitation to the exclusive Annual Leadership Vision Dinner Founder of the Community – $18,000 Includes: Shul Security Recognition plaque in the synagogue lobby 4 High Holiday seats for adults One Deluxe Kiddush Sponsorship High Holiday Honor – Aliyah Trip for two to New York with the Rabbi for a visit to the Rebbe's Ohel Pillar of the Community – $10,000 Includes: Shul Security Recognition plaque in the synagogue lobby 4 High Holiday seats for adults One Deluxe Kiddush Sponsorship High Holiday Honor – Aliyah Gold Membership – $5,000 Includes: Shul Security Recognition plaque in the synagogue lobby 4 High Holiday seats for adults One Kiddush Sponsorship Preferred seating at community events Silver Membership – $3,600 Includes: Shul Security Sponsorship of a community program of your choice 4 High Holiday seats for adults Family Membership – $2,000 Includes: Shul Security 2 High Holiday seats for adults Single Membership – $1,000 Includes: Shul Security 1 High Holiday seat Select Membership Level Legacy Visionary of the Community - $54,000 ($4,500 Monthly)Visionary of the Community - $36,000 ($3,000 Monthly)Founder of the Community - $18,000 ( $1,500 Monthly)Pillar of the Community - $10,000 ($833 Monthly)Gold Membership - $5,000 ($417 Monthly)Silver Membership - $3,600 ($300 Monthly)Family Membership - $2,000 ($167 Monthly)Single Membership - $1,000 ($84 Monthly) Payment Schedule* Full Payment NowBi-Annual (Sept.1, Mar 1)Quarterly (Sept. 1, Dec. 1, March 1, June 1)Monthly (Sept. 1 - Aug. 1) High Holiday Seating & Services With membership you receive reserved seating for the High Holidays for your family and reservations for your children in the designated youth programs and services. Please select what you plan on attending: Select Your Location for Services and Seats Rosh Hashanah Sept. 11-13 Yom Kippur September 20-21 Chabad of Parkland - 7170 Loxahatchee Rd (With Rabbis Yosef & Shuey Biston)Chabad of West Parkland - Park Trails & Marriott Hotel (With Rabbi Mendy Gutnick) Names for reserved seating (and any seating request)* Additional seats above member allotment are $118 per seat Names and ages for children attending designated Children's Services (Ages 2 - 12) Reservation Required Attending Other Services Family Service Rosh Hashanah - Park Trails Elementary - Saturday & Sunday Sept. 12 & 13 - 1:00pm - 2:00pmFamily Service Yom Kippur - Marriott Hotel (Heron Bay) - Monday September 21 - 1:30pm - 2:30pmFamily Service & Tashlich Rosh Hashanah - Chabad of Parkland Sunday Sept. 13th - 5:30pm - 6:30pm Check Credit Card Check or Payment Schedule 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 YearBilling Address Street Address City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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