Children Camp / Parivar Camp – 5th to 8th October – 2017 REGISTRATION FORM Surname (required) First Name (required) School Year (required) Address No. & Street (required) Town / City (required) Country (required) Post Code (required) Date of Birth (required) Telephone (required) Mobile (required) Your Email (required) Gender (required) MaleFemale Please state any essential medical/dietary requirements or ALLERGIES Med. Card No Parents Name (required) Emergency Contact Number (required) Parents Email ID (required) "PAYMENT - Please make EFT (electronic fund transfer) using below bank links and paste EFT receipt number in below field" https://www.commbank.com.au/ http://www.anz.com.au/personal/ http://www.nab.com.au/ http://www.westpac.com.au/ http://www.stgeorge.com.au/ http://www.bankofmelbourne.com.au/ The Bank details for an online transfer are as below Bank Account Name : HSS (VIC) – Bank : NAB BSB No. : 083175 Account No. : 117264894 EFT Reference Field (required)