Registration Form
Fill out the form carefully for registration
Name
*
Dr
First Name
Last Name
Mobile Number
*
050xxxxxxx
Email
*
example@example.com
AKMG Region
*
Please Select
R1
R2
R3
R4
R5
R6
R7
R1/R2/R3/R4/R5/R6/R7
Register for Kalikkalam as "SINGLE", "COUPLE" OR "FAMILY". And / OR Guest if applicable
*
Please Select
Single
Couple
Family
Guest
Number of Adults in your family attending Kalikkalam(Children above 13 years to be considered as Adults)
*
Please Select
0
1
2
3
4
5
6
7
9
10
Number of Children Below 13 years in your family Attending Kalikkalam (enter 0 if nil)
*
Please Select
0
1
2
3
4
5
6
7
8
9
10
Number of Guest Adults (enter 0 if nil) Extra AED 100 Per head)
*
Please Select
0
1
2
3
4
5
Number of Guest Children Below 13 years (enter 0 if nil) Extra AED 50 Per head
*
Please Select
0
1
2
3
4
5
Payment
*
prev
next
( X )
Single
100.00
AED
Quantity
1
2
3
4
5
6
7
8
9
10
Couple
150.00
AED
Quantity
1
2
3
4
5
6
7
8
9
10
Family
200.00
AED
Quantity
1
2
3
4
5
6
7
8
9
10
Guest (Adult)
100.00
AED
Quantity
1
2
3
4
5
6
7
8
9
10
Guest (Child Below 13)
50.00
AED
Quantity
1
2
3
4
5
6
7
8
9
10
Submit
Should be Empty: