2024 HS Classes/Activity Participant Registration Form

 DO NOT FILL FOR CULTURAL SHOWS

HinduSamaj-Jain Temple & Cultural Center

3 Brown Road, Wappingers Falls, NY 12590 Phone: 845-657-1660

Website: www.hindusamajtemple.org

Sign in to Google to save your progress. Learn more
Email *
Participant Full Name *
Age *
Gender *
Contact Number *
Participant Email Address ( If different from above)
Class Name(s) *
Emergency Contact Name *
Emergency Contact Relationship *
Emergency Contact Number *
Relevant Allergies *
Payment information (cash, check, online payment)
Please indicate the amount paid per class/month/year
If no payment please indicate NONE
 *
Transaction ID (if applicable)
Terms and Conditions:

I understand that the registration fee is non-refundable.
Fees are subject to change as per board approval.

I agree to abide by the rules and guidelines set by the temple/cultural center during the classes.

I authorize the temple/cultural center to use any photographs or videos taken during the classes for promotional purposes.

By signing below, I acknowledge that I have read and agree to the terms and conditions.

In case of minors, parents can sign below
 *
Date *
MM
/
DD
/
YYYY

Participant - Waiver of Liability

I voluntarily participate in activities organized by HinduSamaj-Jain Temple & Cultural Center I understand that there are inherent risks associated with these activities.

I acknowledge that HinduSamaj-Jain Temple & Cultural Center has established guidelines and rules for participant safety.

I agree to abide by these guidelines and rules during my participation.

I release HinduSamaj-Jain Temple & Cultural Center, its officials, employees, and volunteers from liability for any injuries or damages that may occur during these activities.

This waiver covers activities on HinduSamaj-Jain Temple & Cultural Center premises and related off-site activities.

I understand that I am responsible for my own well-being and safety during these activities.

In case of emergency, I consent to receiving medical treatment as deemed necessary.

I grant permission to HinduSamaj-Jain Temple & Cultural Center to use any photographs or videos taken during the activities for promotional purposes.

This waiver is binding on me, my heirs, executors, and assigns.

By filling out this form and signing below, I acknowledge that I have read and understood the terms and conditions of this waiver of liability and agree to be bound by them.


In case of minors, parents can sign below

 *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
reCAPTCHA
PrivacyTerms
This form was created inside of Hindu Samaj Inc.