Balavihar 2011-12 Registration
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1. Balavihar 2011-12 Registration Form - Hindu Temple Association of DE
Registration for 2011-12 School year for Balavihar at the Hindu Temple in Hockessin, Delaware
1
. REGISTRATION FOR BALVIHAR at MAHALAKSHMI DEVASTHANAM
Balavihar classes for 2011-2012 will start on September 11th 2010. Dates: Sept 11-Dec 18 2011 and Jan 8-May 20 2012
Classes start at 9:45 AM on Sundays.
Parents will get a discount of $25.00 per child if you have more than 1 child. Text books are included in the fees.
Please make checks payable to Hindu Temple Association of Delaware.
REGISTRATION FOR BALVIHAR at MAHALAKSHMI DEVASTHANAM Balavihar classes for 2011-2012 will start on September 11th 2010. Dates: Sept 11-Dec 18 2011 and Jan 8-May 20 2012 Classes start at 9:45 AM on Sundays. Parents will get a discount of $25.00 per child if you have more than 1 child. Text books are included in the fees. Please make checks payable to Hindu Temple Association of Delaware.
2
. Parent's Information
Parent's Information
Name:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Email Address:
Phone Number:
3
. Spouse's Information
Spouse's Information
Name:
Email Address:
Phone Number:
4
. Student/Child's Information
Student/Child's Information
Name
Date of Birth (MM/DD/YYYY)
Gender
Balavihar class completed
5
. Student/Child's Information
Student/Child's Information
Name
Date of Birth (MM/DD/YYYY)
Gender
Balavihar class completed
6
. Student/Child's Information
Student/Child's Information
Name
Date of Birth (MM/DD/YYYY)
Gender
Balavihar class completed
7
. General Information
Registration & Tuition Fees: $100.00 per child. Each additional child $75.00
BEFORE YOU WRITE YOUR CHECK, PLEASE SIGN UP ON THE SNACK & PRASAD SCHEDULE
General Information Registration & Tuition Fees: $100.00 per child. Each additional child $75.00 BEFORE YOU WRITE YOUR CHECK, PLEASE SIGN UP ON THE SNACK & PRASAD SCHEDULE
ALLERGY ALERT – PLEASE INFORM US IF YOUR CHILD OR CHILDREN HAVE ANY SPECIFIC ALLERGIES
Total Amount $
8
. Please check the applicable box if you plan to volunteer at the Temple
Please check the applicable box if you plan to volunteer at the Temple
Teaching
Philosophy
LanguagePrasad / Food Distribution
Front Office Helper
Facility Maintenance
Gardening
Other (please specify)
9
. General Release
I (parent), give my child/children as listed above, permission to participate in the Balavihar, activities being conducted on the premises of the Hindu Temple of Delaware and at other places as needed (picnics, group walk, camps etc.). I understand that The Hindu Temple, Balavihar or any other entity will not be responsible or liable for any personal injury sustained by my children during their stay at the Balavihar. I understand that Balavihar is a completely voluntary activity run by volunteer parents. I agree to be present at all times in the temple or participating/volunteering in Balavihar during the time my child(ren) are in Balavihar Class
General Release I (parent), give my child/children as listed above, permission to participate in the Balavihar, activities being conducted on the premises of the Hindu Temple of Delaware and at other places as needed (picnics, group walk, camps etc.). I understand that The Hindu Temple, Balavihar or any other entity will not be responsible or liable for any personal injury sustained by my children during their stay at the Balavihar. I understand that Balavihar is a completely voluntary activity run by volunteer parents. I agree to be present at all times in the temple or participating/volunteering in Balavihar during the time my child(ren) are in Balavihar Class
Signature of Registering Parent (please write your full name)
Date
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