Clone of Khai Yashua Hanukkah & Immersion Registration 2025 Jacksonville, FL December 3

Name*

First NameLast Name

Hebrew Name if you have one

E-mail*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Number of People Attending*

If registering for more than one person, please list their names and relationship to you. If there are children, include their ages. If you are only registering for one person, please put N/A.

All Days, Wednesday (evening) March 25 - Sunday, March 29, 2026Three Days, Friday, March 27 - Sunday, March 29, 2026Three Days, Wednesday (evening), March 25 - Friday, March 27, 2026One Day, Saturday, March 28, 2026Other

If you selected other for dates of attendance, please list here.

YesNo

How many people will be immersed? (Immersions will be on Sunday morning, March 29, 2026)

I understand.

Signature*

Date

My Products*

One Person Attending All Five Days

Payment in Full

$225.00 one-time payment

One Person Attending All Five Days: Paid in Two Installments

Payment made in two installments of $112.50. Final payment is due 30 days from the day of the first payment with final payment due no later than February 28, 2026.

$112.50 for the first payment then,$112.50 for each month

One Person Attending All Five Days: Paid in Three Installments

Payment made in three installments of $75. Final payment is due no later than March 13, 2026.

$75.00 for the first payment then,$75.00 for each two months

One Person Attending Three Days

Payment in Full

$150.00 one-time payment

One Person Attending Three Days: Paid in Two Installments

Payment made in two installments of $75. Final payment is due 30 days from the day of the first payment with final payment due no later than February 28, 2026

$75.00 for the first payment then,$75.00 for each month

One Person Attending Three Days: Paid in Three Installments

Payment made in three installments of $50. Final payment is due no later than March 13, 2026.

$50.00 for the first payment then,$50.00 for each month

One Person Attending One Day

Payment in Full

$65.00 one-time payment

Two People Attending All Five Days

Payment in Full

$350.00 one-time payment

Two People Attending All Five Days: Paid in Three Installments

Payment made in three installments of $117 for the first payment and $116.50 for the next two payments. Final payment is due 30 days from the day of the first payment with final payment due no later than March 13, 2026.

$117.00 for the first payment then,$116.50 for each two months

Two People Attending Three Days

Payment in Full

$250.00 one-time payment

Two People Attending Three Days: Paid in Two Installments

Payment made in two installments of $125. Final payment is due 30 days from the day of the first payment with final payment due no later than February 28, 2026.

$125.00 for the first payment then,$125.00 for each month

Two People Attending Three Days: Paid in Three Installments

Payment made in three installments of $83 for the first payment and $83.50 for the next two payments. Final payment is due 30 days from the day of the first payment with final payment due no later than March 13, 2026.

$83.00 for the first payment then,$83.50 for each two months

Two People Attending One Day

Payment in Full

$100.00 one-time payment

Three or More People Attending All Five Days

Payment in Full

$450.00 one-time payment

Three or More People Attending All Five Days: Paid in Two Installments

Payment made in two installments of $225. Final payment is due 30 days from the day of the first payment with final payment due no later than February 28, 2026

$225.00 for the first payment then,$225.00 for each month

Three or More People Attending All Five Days: Paid in Three Installments

Payment made in three installments of $150 Final payment is due 30 days from the day of the first payment with final payment due no later than March 13, 2026.

$150.00 for the first payment then,$150.00 for each two months

Three or More People Attending Three Days

Payment in Full

$350.00 one-time payment

Three or More People Attending Three Days: Paid in Two Installments

Payment made in two installments of $175. Final payment is due 30 days from the day of the first payment with final payment due no later than February 28, 2026.

$175.00 for the first payment then,$175.00 for each month

Three or More People Attending Three Days: Paid in Three Installments

Payment made in three installments of $117 for the first payment and $116.50 for the next two payments. Final payment is due 30 days from the day of the first payment with final payment due no later than March 13, 2026

$117.00 for the first payment then,$116.50 for each two months

Three or More People Attending One Day

Payment in Full

$125.00 one-time payment

Khai Yashua Passover & Immersion Registration 2026 Orlando, FL March 25 - 29, 2026