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Raffle Form

Raffle Form


1 Ticket $36 ~ 5 Tickets $99 ~ 10 Tickets $180

Credit Card Number
Exp Date

Please make this: a monthly donation an annual donation.

I'd like to sign up to the monthly Chai Club for $18/month.

I would like to purchase tickets.

Please charge my card $

Email Address:

Name on Credit Card:

Billing Address:


Zip: Phone

Referred by: Comments:

STUFF OUR LAWYERS TOLD US TO TELL YOU: By entering this raffle, participant (and participant's parent/legal guardian) waives all rights to claim punitive, incidental and consequential damages, attorneys' fees or any damages other than actual out-of pocket costs incurred to enter. Winners will assume and be responsible for any licensing, registration, and other fees, and any local, state and federal taxes, including without limitation any applicable sales, use, luxury, income and special taxes. The decision of Chabad of Northeast Queens shall be final on all matters concerning the raffle. By entering the raffle, the participant agrees that his/her name and image may be used for promotional purposes. All participants must be 18 years of age or older. Thank you for supporting a worthy cause. Void where prohibited by law. No purchase necessary.

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