Chinmaya Mission Chicago - Home

You are registering your child(ren) for the 2008 Youth Camp at Yamunotri (July 14th - 20th 2008)
(To register for the Badri Camp - June 23 - 29, 2008, Please click here)

Please view our Yamunotri Camp site for more details

Please visit our Badri Camp site for more details

Registration is a two step process: Form, Confirmation

Parent Information:
* LastName * FirstName
* Address
* City * State * zip
Emergency Contact Emergency Number Like to Volunteer?
Work Phone * Home Phone * Parents email

Student Information Child 1:

Please Enter all Children information below, Age should be as of 7/1/2008
*Lastname *Firstname Date of Birth (MM-DD-YYYY)
* Grade (They will be entering in Sept 2008) Camp Days (If not full, please write dates in the comments field) Male Female
Boarding Transportation (To and From Airport) Pediatrician
(Name & Number)
Medical Issues
Comments

Student Information Child 2:

*Lastname *Firstname Date of Birth (MM-DD-YYYY)
Grade (They will be entering in Sept 2008) Camp Days (If not full, please write dates in the comments field) Male Female
Boarding Transportation (To and From Airport) Pediatrician
(Name & Number)
Medical Issues
Comments

Student Information Child 3:

*Lastname *Firstname Date of Birth (MM-DD-YYYY)
Grade (They will be entering in Sept 2008) Camp Days (If not full, please write dates in the comments field) Male Female
Boarding Transportation (To and From Airport) Pediatrician
(Name & Number)
Medical Issues
Comments