To register for the upcoming couples retreat, please complete this form and proceed to pay by credit card.
Wife's Information
First Name
Last Name
Hebrew Name
Mother's Hebrew Name
Date of Birth
Email address
Cell Phone
Husband's Information
Birthday
Home Information
Phone
Street Address
City
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Date of Marriage
Who referred you to Bais Chana?
Phone number of the person who referred you
Thurs-Sun Fri-Sun Fri-Sat, Shabbat only Please indicate the length of your stay
Name
Age
Your responses below will help us make your learning experience optimal.
Describe previous learning experiences, if any
What are you most interested in studying
What do you hope to gain by attending?
Do you or your spouse have any special dietary requirements or allergies? If yes, please elaborate.
Additional comments? Anything else we should know about you?
Application and Program FeesThursday - Sunday: $1050Friday - Sunday: $780Friday-Saturday (Shabbat only): $420
When making payment include the $50 Application Fee and Retreat Fee, as above.
Rates include hotel accommodations and amenities (as below), all classes and workshops, and three kosher gourmet meals daily. Childcare is available for children 4 and under, at additional cost.
"Shabbat-only reservation” (check in Friday afternoon and stay through the end of Shabbat) requires that you check out of your room by 1 pm Saturday. The hotel will store your luggage safely until your departure. We will have a hotel room available after 1 pm designated for the use of Shabbat-only guests.Cancellations received more than 30 days from your date of arrival will be fully refunded. Cancellations received 30 days or less from your date of arrival, will be refunded at 50% of the total fees.
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