Camp Registration Form - "9th Family Camp "-----------""
Child/Teenager Info
Add Child
First Child/Teenager Full Name *
Birth Date *
Gender *
Male
Female
School Name
Is the child attending a Balvihar class?
Sevika Name
Place
Email ID
Contact
Remove Child
Second Child/Teenager Full Name *
Birth Date *
Gender *
Male
Female
Other
School Name
Is the child attending a Balvihar class?
Sevika Name
Balvihar Class
Email ID
Contact
Remove Child
Third Child/Teenager Full Name *
Birth Date *
Gender *
Male
Female
Other
School Name
Is the child attending a Balvihar class?
Sevika Name
Balvihar Class
Email ID
Contact
Parent/Guardian Info
Add
Name *
Relation
Parent
Guardian
Mobile *
Email *
Gender *
Male
Female
Age*
Occupation*
Organisation*
Payment Info
Payment Mode *
Online
Cheque
Postal Address *
Area *
City *
Child between Age 2 to 4 Count
Child between Age 5 to 8 Count
Child between Age 9 to 17 Count
Parent/Guardian Count
Pincode *
Any Other Info *
Select Parent Coming *
Select Parent Coming
Yes
No
Age Group
Before
31-Mar-2019
Between
01-Apr To 25-Apr-2019
Between
26-Apr To 30-Apr-2019
2 to 4 Years
RS. 2500 Per Head
RS. 2750 Per Head
RS. 3000 Per Head
5 to 8 Years
RS. 4000 Per Head
RS. 4250 Per Head
RS. 4500 Per Head
9 to 17 Years Adults
RS. 5000 Per Head
RS. 5250 Per Head
RS. 5500 Per Head
Amount
?
Would you like to introduce someone to the Camp/Mission?
References 1
Name
Email ID
Contact No.
References 2
Name
Email ID
Contact No.
Are you a first time Camper? *
Yes
No
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Values - Your SELFie 2016
# GYS Navigating Bharat 2018
Tell Me Why 2019
Are you a Chinmaya Mission Member?
Would you need transportation facility? If yes, then we will arrange it at an addditional cost.
Note:
Children will be grouped age wise:
2-4 years, 5-8 years, 9-12 years 13-17 years
A parent/relative MUST accompany children under 9 years of age. Children 9 years and above can participate with or without an accompanying adult. Parents sessions will be taken separately. Only parents/relatives of children participating in the camp will be allowed. Others please excuse non-admission.
Please note that -
(i) atleast one parent must be present during the sessions along with every child who is under 5 years of age.
(ii) The volunteers and sevikas for the camp are neither qualified nor capable of handling children with special needs.
Age Group Classification: e.g - If a child's age is more than 4.5 years, it is considered in the age group of 5-8.
Camp donation is non-refundable. *
I have read and agree to abide by the terms and conditions.*
REGISTER
CLEAR
