Balvihar Camp 2019
For Children from 8 to 15 years of age
20th -- 22nd September 2019
YMCA Shakespear lodge
$120 - early bird if paid by 8th September 2019
Full Name of the Child
Date of Birth of the Child
Does your child have any food allergies?
What suburb do you live in?
Name of Mother/Guardian & Mobile Number
Name of Father & Mobile Number
Mode of Payment
Online: 12-3043-0370005-00 Ref: <Name of Child> - <Balvihar Camp> e.g. Ram - Balvihar Camp
We (parents/guardians) hereby consent our child to attend the Balvihar Camp as chosen above
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