2008-2009 Bala Vihar Registration Form
Click Here if you are Returning Bala Vihar 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
Select the center
Kedar - Langhorne, PA
Valley Forge, PA
Bharatiya Temple
Student Information Child 1:
Please Enter all Children information below
*Firstname
*Lastname
Email
*Date of Birth
(MM/DD/YYYY)
* Grade ( As of Fall 2007)
Pre Sch.(Age less than 5 on 9/1/07)
KG
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 2007)
Pre Sch.(Age less than 5 on 9/1/07)
KG
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 2007)
Pre Sch.(Age less than 5 on 9/1/07)
KG
1
2
3
4
5
6
7
8
9
10
11
12
Male
Female
Comments
