International Children's Retreat at Mount Abu, Rajasthan, India 2023

Full Name of one Parent/ Guardian *

Country of residence *

City / Town

Email address of Parent / Guardian *

@

Mobile number

Name of your child (children) *

Age of your Child (children) *

Gender of your children

Brother

Sister

Language spoken at home? *

Does your child speak English ? *

Yes No

What Centre do you attend ? *

What is the name and email ID of your Centre Coordinator ?

What is the Mobile number of the Centre Coordinator ?

Do you listen to The Murli ? *

No Yes

Do your children listen to the Murli ? *

No Yes

Have you done the Raja Yoga course ?

No Yes

Has your child (children) done the Raja yoga course ?

No Yes

Does your child (children) have any medical condition(s).

Does your child(ren) take medication? *

No Yes

authorisation letter

Please confirm that you have read the above Letter of Authorisation and agree to its contents. Please type your name and today's date below: *