Registration Form 

 

Instructions:

Register with this form if you are paying via Zelle, Venmo, or cash.

1. Fill out the form and select the payment mode in the drop-down.

2. Submit the form.

3. Make your payment. To pay by Zelle or Venmo:

Zelle. 7734547709

Venmo: @Bruria-kohen

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When paying with cash, you must print out and attach this completely filled-out registration form. Each person sharing a room needs to fill out a registration form.

Please mark on the envelope – Rokdim Chicago Beketzev Acher 2024

Make sure you include a printout of this registration form. Your payment can’t be processed without a registration form.

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CANCELLATION POLICY: In order to cancel your registration and receive a refund, a written notification needs to be received by email according to the dates listed below:

March 16-April 30: 50% non-refundable

Beginning May 1: Non-refundable