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Registration Form


Childrens Summer Camp 2017

at JVB Preksha Meditation Center
August 7 -11, 2017
9:00 am - 4:00 pm
$150/child
* Parent's First Name
* Parent's Last Name
Address
City
State
Zip
* Phone
* Email
Children (ages 6-8 years)
Child 1: Name
[$150]
Child 2: Name
[Add $150]
Children (ages 9-11 years)
Child 3: Name
[Add $150]
Child 4: Name
[Add $150]
Health Information
Food Allergies
Emergency Contact
Emergency Phone
Total Attendees
I/We have read and agree to the Terms and Conditions.
 

Terms and Conditions:
I hereby stipulate that my child(ren) is(are) physically sound to proceed with instructions in Various Camp activities including Meditation and Yoga. It is further agreed that all exercises and lessons shall be undertaken at my own risk and JVB Preksha Meditation Center shall not be liable for injuries, damages or claims to myself or my property arising out of, or connected with, the use of services or facilities of JVB Preksha Meditation Center or the premises in which the same is located. JVB Preksha Meditation Center accept no responsibility of any kind for the Children Summer Camp Activities. I do hereby release and discharge JVB Preksha Meditation Center from all such causes of action.