Summer Camp 2023 – Offline Student Registration

Donation Amount:

£ 125.00

Select Payment Method

Credit/Debit Card
Offline Donation

Personal Info

Title *

First Name *

Last Name *

Email Address *

Child's Details

Child's First Name

Child's Surname

Address Line 1

Address Line 2

Town

City/County

Postcode

Mobile Number

Child's Date of Birth

Male Female

Father's Name

Mother's Name

Medical Conditions and Food Allergies

If any, please state child's medical conditions. If none put NA

Please state if your child has any food allergies. If none put NA

Emergency Contact Details

Emergency Contact 1: Full Name

Emergency Contact 1: Contact Number

Emergency Contact 1: Relationship

Emergency Contact 2: Full Name

Emergency Contact 2: Contact Number

Emergency Contact 2: Relationship

Data Protection and Consent

Yes No

By ticking this box I give consent to SHREE SWAMINARAYAN SATSANG (S.S.S) to use my personal Data (including any personal Data that might subsequently be provided to SHREE SWAMINARAYAN SATSANG (S.S.S). DATA PROTECTION: SHREE SWAMINARAYAN SATSANG (S.S.S), also known as Stanmore Temple, Shree Swaminarayan Temple Stanmore, and associated entities under SHREE SWAMINARAYAN SATSANG (S.S.S), would like to continue to send you news and information about our religious and social activities, events and services by email, text, telephone or other electronic methods.

Payment is non-refundable

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Billing Details

Country *

Address 1 *

Address 2

City *

County *

Zip / Postal Code *

Donation Total: £125.00