Home About Us Children's Corner Teachers & Parents Magazine HHC Events & News Links
Hindu Heritage Camp

Hindu Swayamsevak Sangh

Hindu Heritage Camp - 2004

Registration Form

Please fill out separate form for each child.

Child's First Name:

Last Name:

Date of Birth (mm/dd/yyyy) :

Mother's Name:Father's Name:

Phone (Home): Phone (Office):

Phone (Emergency):Email:

Street Address:



Medical Insurance: Medical Insurance Company Name:

Group #: Subscriber #:

Personal Physician's name:Physician's phone:

Parent's Consent

  • I hereby release Hindu Swayamsevak Sangh and its officers of any liability for any accidents or injuries my child may incur while attending the Camp.

  • I and my health insurance company are completely responsible for the payment of all expenses incurred for any kind of medical and/or surgical treatment as a result of my child's participation in the camp.

  • In the event of an emergency where treatment by a doctor is deemed necessary, I hereby give permission for a representative of the Hindu Swayamsevak Sangh to authorize physician(s) and hospital personnel to give my children anesthesia and/or perform whatever medical and/or surgical treatment deemed necessary at such time in my child's best interest.

Signature of the Parent/Guardian Date:

Go to top