Children, if attending convention
PAYMENT OPTIONS Make payment via Zelle to 2024FOKANA@gmail.com OR Make check for the total amount payable to “FOKANA”. Mail Form and check to FOKANA – 2024 Convention P.O. Box 1261 Rockville, MD 20849
I, as an attendee of the FOKANA 2024 Convention, acknowledge and accept responsibility for safety, liability and medical insurance for me and the members listed on the form. I will not hold FOKANA or the attendees of the convention responsible for the safety and liability during our stay at the site. In case of emergency, I give my permission for emergency medical treatment. I agree to abide by local, State and Federal laws. Any damages to the hotel room / hotel property will be my responsibility. I understand that no refunds will be issued.
Credit Card Payment Method
FOKANA Registration Committee Use Only
Mode of Payment: Zelle / Check No. / Credit Card # & Exp date / Cash
“I here by confirm that the information disclosed above are true to the best of my knowledge. Any incorrect details may result in cancellation of existing registration and redoing the process. I understand that this is the preliminary step in registration process and this process is complete only when I make the full payment. I also understand that registration committee will allocate hotel rooms only after I make the full payment”
