Register For Cobb Balvihar 2024-25

Father's Name:*

Fill Name

Father's Name:

Cell Phone*

(Father)

Cell Phone

Email Address*

Father

Email Address

Mother's Name*

Full name

Name

Cell Phone

(Mother)

Cell Phone

Email Address

(Mother)

Email Address

Residential Address*

Address line one

City

Country

State

Zip Code

Emergency Contact Name*

Name

Emergency Phone*

Phone

Number Of Children*

CHILD 1 DETAILS

Name

Is new Student?

Yes

Gender*

Male

Female

Date Of Birth*

Age must be below or equal to 31 August 2019

08/31/2019 ×

Grade At School*

T-Shirt Size*

Write Here

Physical / Medical Disabilities If Any

Write Here

Registration Fees*

$240

CHILD 2 DETAILS

Name

Is new Student?

Yes

Gender*

Male

Female

Date Of Birth*

Age must be below or equal to 31 August 2019

Select Date ×

Grade At School*

T-Shirt Size*

Write Here

Physical / Medical Disabilities If Any

Write Here

Registration Fees

$230

CHILD 3 DETAILS

Name

Is new Student?

Yes

Gender*

Male

Female

Date Of Birth*

Age must be below or equal to 31 August 2019

Select Date ×

Grade At School*

T-Shirt Size*

Write Here

Physical / Medical Disabilities If Any

Write Here

Registration Fees

$220

Additional Donation

Total Amount (Registration + Donation )

$ 0

Payment Method*

Paypal Account

Pay through PayPal

You will be redirected to PayPal checkout page once you submit. After you complete your payment, you will be redirected back to our site with a confirmation.

By registering my/our child(ren) in Balvihar Hindi School, I/we give full permission for him/her/them to participate in all activities conducted by the program. I/We understand that in the event of any unforeseen emergencies, Vishwa Hindu Parishad of America, Inc. (VHPA), its members, or any agents or officers or volunteers of VHPA are permitted to provide immediate help to my/our child(ren). I/We hereby release Vishwa Hindu Parishad (World Hindu Council) of America, Inc. (VHPA) and/or its officers, directors, members, agents, employees, beneficiaries, or successors in interest from any and all liabilities arising out of any transaction or occurrence that may occur during participation in any Balvihar activity, including, but not limited to, any injury arising out of the negligence of VHPA and I/we hereby release VHPA from any and all current or future legal claims that may arise out of said transactions or occurrences.

I/We, along with our child/children agree to comply with Balvihar policies in effect as announced from time to time.

I/We authorize Balvihar management to contact us on phone numbers and email addresses provided in this registration form.

I/We acknowledge that I/we have been advised to make sure that my/our child(ren) is(are) physically and mentally fit to participate in sports, physical exercises, yoga, meditation, and other activities of Balvihar.

I/We hereby give permission to VHPA to use any pictures, videos, or other intellectual property of my/our children created during the course of Balvihar, or any officially sanctioned Balvihar event in any publication, or website or newsletter or any other such materials and media not mentioned herein.

I/We certify that all informations provided in the form are accurate and I/We will not hold Balvihar responsible for any inaccuracies in the transcripts/certificates or such other materials as a result of inaccuracies if any in this form.

I/We believe in, practice and/or respect the spiritual and religious principles and practices having roots in Bharat (India).

I/We understand that fees once paid are non-refundable.

I accept the Terms & Conditions mentioned Above.*

9 plus 4 equals?*

Prove you are a human

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CHILD 1 DETAILS

CHILD 2 DETAILS

CHILD 3 DETAILS

Pay through PayPal

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