KERALA CENTER
Year 2001 Youth Festival
Registration Form
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1. Name ( Last, First, MI )_______________________________________________________________
2. Date of Birth _______________________________ 3. Citizen Y/N
4. Grade in School/ College_____________________________________________
5. Parent's name & Address_____________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
6. Phone_______________________________
7. Best time to call __________________________________
Youth Festival Part 1
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| Name Items entering |
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| _________________________________________________________________________ |
| _________________________________________________________________________ |
| _________________________________________________________________________ |
Youth Festival Part 2
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| Name Items entering |
| _________________________________________________________________________ |
| _________________________________________________________________________ |
| _________________________________________________________________________ |
| _________________________________________________________________________ |
Year 2001 Beauty Pageant ( Kerala )
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Name_______________________________________________________________________
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Fees enclosed, cash/check ( payable to Kerala Center 2001 Celebrations)
$_______________________________________________________________
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I have read and understood the rules and regulations and shall abide by them.
Signature__________________________________
Date: __________________
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Counter signed by parent__________________________________
Name ________________________________ Date: __________________
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