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Summer Splash/ Granny’s Courtyard

Tell us about yourself…

Ur Name:

First Name

Middle Name

Last Name

Momma:

First Name

Middle Name

Last Name

Papa:

First Name

Middle Name

Last Name

Everyone sends you birthday greetings on:

Date of Birth (dd/mm/yy)

Everyone sends you posts at:

Complete Postal Address

Tring Tring:

Phone Number

You study at:

School Name and Address

Your Principal’s name:

School Telephone number:

Your favourite pastime:

Photo

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Summer Splash: Registration form

Parents/ Guardian Details…

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Detail of Payment Paid Rupees (In Words) ………............................................................................................ (In Figures)………………………. By Cash. ……………………… Date……………………….Cash received by UAS representative (Name)………. …………………………………Sign ………………………Date ………………………Any additional Comments ………………….. …….…………………………………………………………………………………………………………………... I Parent / Guarantee / Authorized Signatory, Mr. / Ms: ______________________________________ Of participant Name: ___________________________ hereby agree that I / we have read the rules and regulations for the participation. We shall not hold UAS or any other body responsible for any reason whatsoever arising out of the participation of the above mentioned person for the camp. I / We also declare that the participant is totally fit to take part in the above camp and is free from any and all kinds of diseases or injuries preventing him / her from taking part in the above mentioned camp. I shall also attach any and all medical documents along with the registration form and clearly explained any and details required to be carried out with respect to the above mentioned participant. Signed by: ……………………………… …………………………………… Authorized Signatory No. 1 Authorized Signatory No. 2 Date: …………………………………… Place: ………………………………

Father’s Name:

First Name

Middle Name

Last Name

Mother’s Name:

First Name

Middle Name

Last Name

Father’s Mobile number and email id:

Mother’s Mobile number and email id:

Father’s Occupation and

Address of workplace:

Mother’s Occupation:

Child’s Blood Group:

Mention Allergies (if any):

Any Injury/ Medical History:

Does the child have any fear/phobia:

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TERMS AND CONDITIONS

Entries on first come first serve basis (last dates if any declared are only indicators).

The program itinerary is subjected to change.

The fees include raw materials for all days.

There will be a performance on the last day of the camp which is open for all.

Please report 15 min prior to the camp start time.

We discourage the use of cell phones during the sessions. No camper is allowed to carry Mobile phones or any other valuable items along with him/her. Do inform the Facilitators, if any. Call on 9650201114 in case of urgency.

The campers should attend the camp in the recommended clothing (lose tracks and tees and shoes) and we also recommend an extra pair to be carried.

Fees once paid will not be refunded or returned or transferred. This is true only if the camp is not cancelled by UAS.

The program is aimed towards giving the campers varied options in different art forms that they can develop further in future.

Parents would not be allowed to be present on the days of the camp except some special invited occasions.

In case if any camper misbehaves or behaves in a way which is not approved by the UAS then parents will be informed.

Although thorough care would be taken to ensure the safety of the camper, UAS or any other organization/individual would not be responsible for any injury that may take place during the camp. (Though in such situations first aid and initial medical assistance will be available).

Any damages caused by the campers will levied on the parents at actual for replacing.

Management reserves the rights to cancel or postpone programs in case of any unforeseen circumstances or any reason affecting the proceeding of this event.

Campers absent on any particular day of the camp for any reason will not be guaranteed any cover up session for the same.

Any and all rules which would be informed to the campers and parents from time to time whether verbal or written will be implied even if not mentioned here and will form part of this declaration and terms and conditions.

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-------------------------------------------------------------------------------Receipt--------------------------------------------------------------

Amount paid (in words) Rs……………………………………………………………… (In figures)………………………………. To (name of UAS representative)……………………………………………………………………………………………………… Signature………………………………… ………… Date……………………….Place………………………..