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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