7250 Ox Road,
Fairfax Station VA 22039
703-323-8849

Registration Form – 2017 - 2018

For Inquiries contact the coordinator via email: xyz@gmail.com
One form per family – applicable for returning and new families
(Children ages 3 – 18)

Classes
  • Pre-P1 (3 – under 5yrs)
  • P 1 (5 – 6 yrs)
  • P2 (7 – 8 yrs)
  • M1 (8 – 10 yrs)
  • Youth (over 10 – 18 yrs)
Fees and Charges
  • Gurdwara - No charge
  • Supplies (non-refundable fees)
    • Books - ~ $15 each child
    • Activity fee - $50.00 first child
      • $40.00 – second child (sibling)
      • $30.00 – third child (sibling)
Child 1*
Date of birth: *
Class *
Child 2

Child 3

Father's Name
Cell #
Mother's Name* Cell #*
Home address:
City :
State :

Home#:
Primary email ID: *
Other email ID:
Do you have child health insurance ?

* Terms & Conditions of Registration :
  • Program duration would be 9 months (Sept. 2017 thru June 2018)
  • Classes would be held once a week on Sunday at Gurdwara, Virginia.
  • Timing of the classes: 9:30 am – 11:00 am
  • Classes is run by volunteers. For efficient running of the program , parents are expected to volunteer and share responsibilities in various activities of Classes and Gurdwara.
  • Parents of children ages 3 – 5 yrs. old (Pre-P1) class must sit with the child in the class.
  • Please read Classes information document for further information or get a copy by contacting the coordinator(email info.webbers@gmail.com)
  • Parents are expected to follow all the rules and regulations applicable to the program, including Gurdwara policies. For further information, please contact Gurdwara PoC at test@gmail.com

Thank you so much for spending time on Classes web page. If you wish to register your child, please fill out the form above and submit online.