Chinmaya Mission Chicago - Yamunotri

YOU ARE REGISTERING YOUR CHILD(/REN) AT OUR Yamunotri Center (30877 N Fairfield Rd, Grayslake, IL 60030)
2011-2012 Bala Vihar Registration Form
Fees: $200/1 child (or) $350/2 children (or) $450/3 or more children
Click Here if you are Returning Balavihar Family

Note for New Parents - Once you register for 2011-2012 Bala Vihar year and if your child is 4+ years old you can bring your child immediately to Bala Vihar classes. Our Summer session is only on Saturdays from 2 PM to 4 PM from June 11th, 2011 to August 27th, 2011!
Parent Information:
* LastName * FirstName (Father & Mother)
* Address
* City * State * zip
Emergency Contact Emergency Number
* Home Phone Father Work Phone Mother Work Phone
* Parents email Requested Session 1 Saturdays (10:00 AM - 12:00 PM)    Session 2 Saturdays (2:00 PM - 4:00 PM)

Student Information Child 1:

Please Enter all Children information below
*Firstname *Lastname email
*Date of Birth (MM/DD/YYYY) * Grade ( As of Fall 2011) Male Female
Comments

Student Information Child 2:

*Firstname *Lastname email
*Date of Birth (MM/DD/YYYY) * Grade ( As of Fall 2011) Male Female
Comments

Student Information Child 3:

*Firstname *Lastname email
* Date of Birth (MM/DD/YYYY) * Grade ( As of Fall 2011) Male Female
Comments

YOU ARE REGISTERING YOUR CHILD(/REN) AT OUR Yamunotri Center (30877 N Fairfield Rd, Grayslake, IL 60030)
(To register for BALA VIHAR at our Badri center (11 S 80 RTE 83, WILLOWBROOK, IL 60527) - Click Here )