Printed fromChabadWestBoca.com

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Israel Loud & Proud

Take home a pair of Converse High Tops. For EVERY shoe designed, one pair will be sent to a child in ISRAEL.

This form is currently closed.

This event is sold out. We hope to have you at a future event.
This event is for children ages 5-16.
Adults should accompany their child.
Full Name*
First Name Last Name

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail*
Phone Number*

Area Code Phone Number
Number of children joining:* Ages 5-16
Important: Converse All Stars run a half size large.

Little Kids Size Chart: Click here
Sold out sizes: 1Y, 2.5Y

Bigger Kids Size Chart: Click here
Sold out sizes: Mens 5 - Womens 7, Mens 10 - Womens 12, Mens 11 - Womens 13

Disclaimer: if shoe size chosen does not fit, exchanges are NOT guaranteed and will be subject to availability.
Child #1 Shoe Size*
Child #1 Age*
Child #2 Shoe Size*
Child #2 Age*
Child #3 Shoe Size*
Child #3 Age*
Child #4 Shoe Size*
Child #4 Age*
Child #5 Shoe Size*
Child #5 Age*
Would you like to donate or sponsor this program?*

YesNo
I want to donate:

$36 USD$50 USD$100 USD$180 USD
I want to Sponsor:

$1800
Total Charge

$0.00 USD

Payment Method*

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

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