Gopal Kidz Summer Camp Registration
Serving the mission of His Divine Grace A.C. Bhaktivedanta Swami Prabhupada. Sri Krishna Balarama Mandir, 680 E Calaveras Blvd, Milpitas, CA 95035 408-825-4555, gopalkidz@ihf-usa.org | www.facebook.com/gopalkidz
Child's Name
*
First Name
Last Name
Child's Gender
Male
Female
Age Group
6 to 10 years
3 to 5 years
Date Of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Please enter your Child's DOB
Child's Age
*
Father's Name
*
First Name
Last Name
Father's Phone Number (WhatsApp)
*
-
Area Code
Phone Number
Mother's Name
*
First Name
Last Name
Mother's Phone Number (WhatsApp)
*
-
Area Code
Phone Number
Father's Company Name (Work)
*
Mother's Company Name (House wife if not working)
*
E-mail
*
Camp Enrollment
Camp 1 - June 2nd to 13th June
Camp 2 - June 16th to June 27th
Camp 3 - July 14th to July 25th
Camp 4 - July 28th to Aug 8th
Payment
*
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Morning Session ( 9:00 am to 1:00 pm)
$299.00
$
299.00
No of Camps
Item subtotal:
$0.00
$
0.00
Afternoon Session (2:00pm to 6:00pm)
$299.00
$
299.00
No of Camps
Item subtotal:
$0.00
$
0.00
Full Day Session (9:00 am to 6:00pm)
$599.00
$
599.00
No of Camps
Enter coupon
Apply
Total
$0.00
$
0.00
Any Special Requests like Food allergies, please mention here.
Is your child fully potty trained (no diapers or pull-ups)?
Please Select
Yes
No
Not applicable ( For Above 5 years)
In case of any questions? Please email to gopalkidz@ihf-usa.org.
Register & Complete Payment
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