Spiritualtouch Registration Form

First Name*:

Last Name*:

Date of Birth *:

Address Line 1*:

City*:

Country *:

School*:

Blood Group*:

Which centre would you like your child to join?*:

Father's Name*:

Father's Contact No*:

Mother's Name*:

Mother's Contact No:*:

Emergency Contact No*:

Talents you would like to share with Spiritualtouch:

How did you find out about Spiritualtouch?

If Friends / Family / Others, please specify:

Middle Name*:

Gender*:

Age:

Address Line 2:

Zip / Pin Code*:

Residential Phone No:*:

Standard:*:

Allergies: (if any)

Father's Occupation*:

Father's Email ID*:

Mother's Occupation*:

Mother's Email ID:*:

Your child enjoys doing:

Comments:

1. As a parent/ guardian you have permitted your child to participate in the activities solely at your and his/ her own risk and discretion, without any influence, inducement, force or coercion by anybody.
2. It shall be your duty to fully disclose and inform the Organisers at the time of filling this form if your child/ward has any history of medical problems/ any sort of health issues or allergies etc., whether subtle or manifest or your child/ward needs special attention for any reason. It shall be the sole discretion of the Organisers to permit your child/ward for the event but it is expressly clear that by granting permission to your child/ward to attend and participate in the program, the Organisers do not accept, assume or undertake any responsibility in this regard.
3. The Organisers take or assume no responsibility or liability whatsoever for any loss or damage to the property or belongings of the participants or for any physical injury, illness or death of any participant due to any accident, mishap or any other untoward incident.

I AGREE TO THE TERMS and CONDITIONS