2019 Freedom Day Children's Camp Registration
Please join the Chinmaya Cleveland community for our 2019 Freedom Day Children's Camp.

Date: Sunday, January 20, 2019

Location: Strongsville High School, 20025 Lunn Rd, Strongsville, OH 44149

Time: 1:00 p.m.-5:00 p.m.

Acharya Vivekji will lead this camp for children (Ages 5-8th grade). Acharya Sumanji and Acharya Shankarji will assist as well along with many volunteers.

Registration will require the entire form to be submitted as per the directions below.

Any questions can be directed to chinmayacle@gmail.com

Please visit our website for further information
www.chinmayamissioncleveland.org

2019 Freedom Day Children's Camp
Parent/Legal Guardian Name *
Please provide full name of registering parent (2nd Parent/Guardian can be listed in next Item)
Your answer
Parent/Legal Guardian Email *
Your answer
Phone Number (e.g., in this format 216-111-1111) *
Please provide a best phone number to contact you in case of emergencies
Your answer
Alternate or Backup Phone Number (e.g., in this format 216-111-1111) *
Please provide an alternate/backup phone number to contact you in case of emergencies
Your answer
Mailing Address *
Please provide your mailing address (House Number, Street Name, City, State - ZIP)
Your answer
Additional Parent/Legal Guardian Name *
Please provide full name of 2nd Parent/Legal Guardian and indicate the relationship to the student
Your answer
Additional Parent/Legal Guardian Email *
Your answer
Number of Students Registered *
Please indicate how many students will you register here. Please provide the Full Name, age, gender, and diet and allergy information of each person on the form.
Your answer
Student #1 Full Name *
Please provide the First Name & Last Name of Student #1
Your answer
Student #1 Age *
Please provide the Age of Student #1
Your answer
Student #1 Gender *
Please indicate the Gender of Student #1
Student #1 Diet and Allergies *
Please indicate any Dietary Restrictions and Medical/Allergy Information
Your answer
Student #2 Full Name *
Please provide the First Name & Last Name of Student #2
Your answer
Student #2 Age *
Please provide the Age of Student #2
Your answer
Student #2 Gender *
Please indicate the Gender of Student #2
Student #2 Diet and Allergies *
Please indicate any Dietary Restrictions and Medical/Allergy Information
Your answer
Student #3 Full Name *
Please provide the First Name & Last Name of Student #3
Your answer
Student #3 Age *
Please provide the Age of Student #3
Your answer
Student #3 Gender *
Please indicate the Gender of Student #3
Student #3 Diet and Allergies *
Please indicate any Dietary Restrictions and Medical/Allergy Information
Your answer
Student #4 Full Name *
Please provide the First Name & Last Name of Student #4
Your answer
Student #4 Age *
Please provide the Age of Student #4
Your answer
Student #4 Gender *
Please indicate the Gender of Student #4
Student #4 Diet and Allergies *
Please indicate any Dietary Restrictions and Medical/Allergy Information
Your answer
Where did you hear about this workshop? *
Required
Please let us know if you are able to volunteer for this event
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service