Adelaide Family Shibir 2021 Registration

    First Name (required)

    Sur Name (required)

    Spouse First Name (required)

    Spouse Sur Name (required)

    Your Gender (required)
    MaleFemale

    Date of Birth (required)

    Medicare Id(required)

    Number of Children (required)

    Please state any essential medical/dietary requirements or Allergies

    Contact Details

    Email (required)

    Mobile Number (required)

    Landline Number

    Address

    Suburb

    City

    State

    Country

    Post Code

    Emergency Contact Details

    Parent/Next of Kin Emergency Contact Number 1

    Parent/Next of Kin Emergency Contact Number 2

    Please credit $65 per Adult and $50 Kids (Ages 5-12 years). Kids under Age 5 free.
    Hindu Swayam Sevak Sangh, Adelaide
    Bank: BankSA Limited
    BSB: 105-900
    Account number: 970 633 540
    Reference Message: [FirstName]-[LastName]

    Transaction Receipt Number

    I understand the risk involved in camp activities. I am aware that the camp participants may use public or private transport during the course of camp activities. I indemnify HSS from any claims arising out of mishap / accident/ injury during the camp stay in or out of camp site.

    Event Calendar

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