2009-2010 Balavihar Registration Form
Click Here if you are Returning Balavihar Family
Parent Information:
* LastName
* FirstName (Father & Mother)
* Address
* City
* State
* zip
Emergency Contact
Emergency Number
* Home Phone
Father Cell Phone
Mother Cell Phone
* Parents email
Student Information Child 1:
Please Enter all Children information below
*Firstname
*Lastname
Email
*Date of Birth
(MM/DD/YYYY)
* Grade ( As of Fall 2009)
Toddler(Age less than 4 on 9/1/08)
Pre-K(Age 4 on 9/1/2009)
KG(Age 5 on 9/1/2009)
1
2
3
4
5
6
7
8
9
10
11
12
Male
Female
Comments
Student Information Child 2:
*Firstname
*Lastname
Email
*Date of Birth
(MM/DD/YYYY)
* Grade ( As of Fall 2009)
Toddler(Age less than 4 on 9/1/08)
Pre-K(Age 4 on 9/1/2009)
KG(Age 5 on 9/1/2009)
1
2
3
4
5
6
7
8
9
10
11
12
Male
Female
Comments
Student Information Child 3:
*Firstname
*Lastname
Email
* Date of Birth
(MM/DD/YYYY)
* Grade ( As of Fall 2009)
Toddler(Age less than 4 on 9/1/08)
Pre-K(Age 4 on 9/1/2009)
KG(Age 5 on 9/1/2009)
1
2
3
4
5
6
7
8
9
10
11
12
Male
Female
Comments
