9th Patotsav of Piyuda Ghanshyam Maharaj & Youth Shibir Registration Form

Registration Deadline: July 10th 2023

Date of Utsav: 25th July 2023 to 30th July 2023 (Evening Sessions)

Date of Shibir: 25th July 2023 to 28th July 2023 (Morning/Afternoon Sessions)

Location of Utsav & Shibir: Beth-El Temple | 67 US-206, Hillsborough NJ 08844

Youth Shibir Fee: $50 per person

Hotel Accomodation Fee: $10/night per person

Please fillout only ONE form per family. You can add additional family members for Patotsav and Shibir below

Main Householder Name*

First NameLast Name

Gender*

Email*

Phone Number*

Please enter a valid phone number.

State *

Country*

Your T-Shirt Size*

Will you need accomodation? *

$10/night per person

Which Days do you need Hotel Accomodation?*

Mode of Transportation*

PlaneCarUndecided

Date of Arrival?*

Utsav Start Date : 25th July 2023

Date of Departure?*

Utsav End Date : 30th July 2023

Meal Count (Please include total people including yourself that will be taking Lunch/Dinner for each day)*

	7/25	7/26	7/27	7/28	7/29	7/30
Lunch
Dinner

** For those travelling, please note mandir will NOT be providing pickup/drop-off service from and to the airport **

Would you like register additional family members for Patosav?*

Additional Family Members Attending Patotsav *

Will you or one of your family member (Youths) below 30 be attending Shibir?*

Age limit 30 years and below

You or Your Family Members (Youths | Age below 30) that will be Attending Youth Shibir*

Liability Waiver: In consideration for being accepted by Shree Swaminarayan Mandir Loyadham for participating in Youth Shibir 2023 - NJ, we parent(s) / legal guardian(s) hereby waive and release Shree Swaminarayan Mandir Loyadham and all its volunteers from liability pertaining to the matters set forth. I expressly and willingly agree to assume complete responsibility for any risk of injury that may arise from any activity or activities held or organized during the Youth Shibir 2023 - NJ. On behalf of myself, my heirs, assigns and next to kin, I waive all claims for damages, injuries and death sustained to me or my property, that I may have against the above-named Released Party relating to such activity. By this waiver, I assume any risk and takes full responsibility and waive any and all claims of personal injury, including severe bodily injury, damage to personal property and death relating to all activities associated with Shree Swaminarayan Mandir Loyadham and its volunteers, including but not limited to receiving spiritual education, recreational activities, using facility and its equipment’s on and off premises. If any injured from said activity, I will not hold Released Party responsible even if the injuries or the losses were caused by negligence on my party or the Released Party or any other party under or affiliated with the above-named Released Party. I do not have any physical limitations, medical ailments, physical or mental disabilities that would limit or prevent me from participating in the above-mentioned Youth Shibir 2023 - NJ, and, if required, will obtain a medical examination and clearance.

Connect with us!