REGISTRATION FORM
HUDSON VALLEY SIKH CULTURAL SOCIETY
84 Genung Street,
Middletown,NY 10940
845-343-3080
GURUGHAR_10940@LIVE.COM
Middletown NY Gurmat School Registration Year 2018
Student's Name: *
Date Of Birth: *
Please Check One: Are you a ....? *
Required
Parent/Guardian name: Father Name/ Relationship to Child (if guardian) *
Parent/Guardian name: Mother Name /Relationship to Child (if guardian) *
Parent/Guardian: Complete address *
Contact Details: Cell *
Contact Details: Home Phone
Contact Details: Email *
How would you like to be contacted? *
Does your child understand Punjabi *
Allergies/Medical/Other information *
Language spoken at home *
Emergency Contact: Name & Number *
Is there any other Information that we should know about your child/student? *
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