Full Name* First Name Last Name E-mail* Phone number* Please select from the following options: $1800 - Raffle Sponsor$500 - 28 Raffle Tickets (14 Bonus Tickets Included)$360 - 20 Raffle Tickets (10 Bonus Tickets Included)$180 - 10 Raffle Tickets (5 Bonus Tickets Included)$100 - 5 Raffle Tickets (2 Bonus Tickets Included)$72 - 2 Raffle Tickets$36 - 1 Raffle Ticket Total $0.00 Yes, I'd like to donate the cost of processing this transaction by adding 3% Payment Credit Card Other 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 YearZelle: [email protected]Cashapp: $chabadhasbrouckChecks should be made payable to Chabad in Hasbrouck Heights, 173 Boulevard, Hasbrouck Heights, NJ 07604Billing 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 Thank you for your support! I would like to receive news and updates by email Submit 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 Hasbrouck Heights 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. To submit an entry without a contribution please record your complete name, address, telephone number and email address on a 3" x 5" index card and mail to: Raffle-Chabad of Hasbrouck Heights, 173 Boulevard, Hasbrouck Heights, NJ 07604. Should be Empty: This page uses TLS encryption to keep your data secure.