Hindu Swayamsevak Sangh Australia

HSS Perth Balagokulam Camp – 2017

    First Name (required) Sur Name (required)
    Gender (required) Date of Birth (required) E.g.: 03-Mar-2001

    Medicare Id(required) Bus Transport
    School Year  
    Please state any essential medical/dietary requirements or Allergies
    Contact Details
    Email (required) Mobile Number (required)

    Landline Number Address



    State Country

    Post Code

    Parent/Emergency Contact Details
    Parent/Next of Kin Name

    Parent/Next of Kin Emergency Contact Number

    I understand the risk involved in camp activities. I am aware that the camp participants may use public or private transport during the course of camp activities. I indemnify HSS from any claims arising out of mishap / accident/ injury during the camp stay in or out of camp site.

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