Registration Form for Children’s One-Day Spiritual Retreat Date : 29 th November 2003 Kindergarten 2 Primary 3

R
For Official Use
AMAKRISHNA MISSION

179 Bartley Road, Singapore 539784

Phone : [phone] Fax : [phone]

Email : [e-mail]

Website : www.ramakrishna.org.sg

Registration Form for Children’s One-Day Spiritual Retreat

Date : 29^th November 2003

Kindergarten 2 - Primary 3

NAME OF THE PARTICIPANT

AGE GENDER: M/F

SCHOOL
CLASS (2003)
PARENT/GUARDIAN’S NAME

RELATIONSHIP TO THE CHILD Father / Mother / Guardian

ADDRESS


Email (if any)

CONTACT NO (H) (O)

(HP) 9- (Pgr) 9-

Does the child have any major

Illness that we should be aware of?

Or, is your child taking any medication?

If yes, please let us know about it in brief

Have you ever attended Ramakrishna Mission

Spiritual Retreat ? Yes No

Declaration from the Parent / Guardian

I am aware that the Ramakrishna Mission will take all necessary care to look after my child during the One-Day Retreat. In the event of any mishap / accident I will not hold the Mission responsible for the same.

Signature of Parent/Guardian Date NRIC No.

I enclose herewith my payment of $10.00 by Cash / Cheque made payable to the “Ramakrishna Mission”.

R
For Official Use
AMAKRISHNA MISSION

179 Bartley Road, Singapore 539784

Phone : [phone] Fax : [phone]

Email : spiritual_retreat @ramakrishna.org.sg

Website : www.ramakrishna.org.sg

Registration Form for Children’s One-Day Spiritual Retreat

Date : 30^th November 2003

Primary 4 – Primary 6

NAME OF THE PARTICIPANT

AGE GENDER: M/F

SCHOOL
CLASS (2003)
PARENT/GUARDIAN’S NAME

RELATIONSHIP TO THE CHILD Father / Mother / Guardian

ADDRESS


Email (if any)

CONTACT NO (H) (O)

(HP) 9- (Pgr) 9-

Does the child have any major

Illness that we should be aware of?

Or, is your child taking any medication?

If yes, please let us know about it in brief
Have you ever attended Ramakrishna Mission

Spiritual Retreat ? Yes No

Declaration from the Parent / Guardian

I am aware that the Ramakrishna Mission will take all necessary care to look after my child during the One-Day Retreat. In the event of any mishap / accident I will not hold the Mission responsible for the same.

Signature of Parent/Guardian Date NRIC No.

I enclose herewith my payment of $10.00 by Cash / Cheque made payable to the “Ramakrishna Mission”.

R
For Official Use
AMAKRISHNA MISSION

179 Bartley Road, Singapore 539784

Phone : [phone] Fax : [phone]

Email : [e-mail]

Website : www.ramakrishna.org.sg

Registration Form for Youth Day Camp

Date : 25^th November 2003

Secondary 1 to Junior College

NAME OF THE PARTICIPANT

AGE GENDER: M/F

SCHOOL
CLASS (2003)
PARENT/GUARDIAN’S NAME

RELATIONSHIP TO THE PARTICIPANT Father / Mother / Guardian

ADDRESS


Email (if any)

CONTACT NO (H) (O)

(HP) 9- (Pgr) 9-

Does the participant have any major

Illness that we should be aware of?

Or, is your participant taking any medication?

If yes, please let us know about it in brief
Have you ever attended Ramakrishna Mission

Spiritual Retreat ? Yes No

Declaration from the Parent / Guardian

I am aware that the Ramakrishna Mission will take all necessary care to look after the participant during the One-Day Retreat. In the event of any mishap / accident I will not hold the Mission responsible for the same.

Signature of Parent/Guardian Date NRIC No.

I enclose herewith my payment of $10.00 by Cash / Cheque made payable to the “Ramakrishna Mission”