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2018 APPLICATION


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2018 APPLICATION


Complete the online form below or download PDF and mail to:

8309 White Cedar Circle, Liverpool, NY 13090

CAMP FEE

A $275 fee is required per camper. After completing the online application below you will be re-directed to checkout.  

If A FAMILY cannot afford to THE FEE, financial aid IS available. Please complete the BELOW application and email campkhanda@gmail.com or call Mohinder Singh at 315-622-2586. 

TRAVEL ARRANGEMENTS

IF TRAVELING ALONE, PLEASE FLY INTO SYRACUSE HANCOCK INTERNATIONAL AIRPORT (SYR) OR TAKE THE TRAIN/BUS TO SYRACUSE AMTRAK/GREYHOUND STATION.  PLEASE SPECIFY WHERE PICKUP IS NEEDED IN THE APPLICATION BELOW. 

PARENTAL/GUARDIAN CONSENT & REGISTRATION
Camper Name *
Camper Name
Gender *
DOB *
DOB
Camper T-Shirt Size *
Limited to 1 per camper and included in the camp fee. Please select one size.
Diet Preference
Home Address *
Home Address
Home Telephone *
Home Telephone
Mobile
Mobile
Emergency Contact 1 *
Emergency Contact 1
Emergency Contact 1 Phone Number *
Emergency Contact 1 Phone Number
Emergency Contact 2 *
Emergency Contact 2
Emergency Contact 2 Phone Number *
Emergency Contact 2 Phone Number
Parental/Guardian Name *
Parental/Guardian Name
We certify that my son/daughter named above is attending the Sikh Youth Camp to be held at CW Center near Syracuse, NY with my consent and will follow the camp rules. I also hereby expressly agree to release, discharge and indemnify and hold harmless the Sikh Foundation of Syracuse, CW Center, and Camp Organizers from any legal or monetary liabilities during my child’s stay at the Camp. I hereby agree that the information in this form is accurate.
Pickup Needed *
General Health Condition & Health Insurance Information
We the Parents/Guardian certify that the health information is correct and complete. In case of emergency, we give permission to the camp to provide routine health care, administer prescribed medication and seek emergency medical treatment including transportation, hospitalization, ordering X-rays or routine tests if required.
Health Insurance Policy Holder
Health Insurance Policy Holder
General Health Conditions
Please obtain an updated immunization record (Tetanus/Diphtheria/Pertussis/Polio/Heamophilus Influenza B/Pneumococcal/HepB/HepA/MMR/Varicella) from your health care provider or school and email to campkhanda@gmail.com
Please Circle any that apply
Note: If your child is on any medication (prescription or non-prescription), either the prescribing physician or family physician's information, phone number, and doctors note are required by New York State Law)
Family Physician Contact Number
Family Physician Contact Number
Sunscreen Usage - Parental/Guardian Permission *
Self Application of Sunscreen: I give permission for the applicant to carry and self apply sunscreen, I understand that the following conditions must be met in order to promote proper and safe use of sunscreen at Camp. Assisted Application: If the applicant is unable to apply the sunscreen themselves, I give permission for camp staff to assist with the application of the sunscreen. Reminder: Sunscreen is considered a drug and shall be checked and logged by the camp as such in accordance with the policies and procedures set forth in their safety plan.
Parental/Guardian Signature regarding Sunscreen Application
Parental/Guardian Signature regarding Sunscreen Application
Meningococcal Meningitis Vaccination Response Form
New York State Public Health Law requires that a parent or guardian of campers who attend an overnight children's camp for seven (7) or more consecutive nights must answer the following questions. *If your child received the meningococcal vaccine before February 2005 called Menomume, please note this vaccines protection lasts for approximately 3 to 5 years. Revaccination with the new conjugate called Menactra should be considered within 3 to 5 years after receiving Menomune.
Parental/Guardian Signature regarding Meningococcal Meningitis Vaccination
Parental/Guardian Signature regarding Meningococcal Meningitis Vaccination
Additional Activities *
I give permission for the camper to participate in all of the following
Indemnification/Waiver of Liability *
Camper Name
Camper Name
Parental/Guardian Signature for Indemnification/Waiver of Liability
Parental/Guardian Signature for Indemnification/Waiver of Liability
Date of Signature
Date of Signature
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What to Bring


What to Bring


Please pack the following items for your Camp Khanda stay!

  • Harmonium / TaBLA

  • FLIP FLOPS FOR SHOWER

  • PAGGS / CHUNNIS

  • HOODIE / LIGHT WEIGHTJACKET

  • LAUNDRY BAG

  • 8 pairs of PANTS (SLACKS / JEANS / SWEATPANTS)

  • 2 PAIRs of sneakers (one ATHLETIC PAIR, one WATER RESISTANT)

  • pajamas for 7 nights

  • 13 pairs of socks

  • 13 pairs of underwear

  • 13 patkas

  • 13 t-shirts

  • 6 pairs of athletic shorts for sports time

  • 2 PAIRS OF SWIM SUITS

  • punjabi suit (for performance /talent show)

  • PILLOW & BED SHEETS

  • SLEEPING BAG

  • 2 TOWELS & TOILETRies

  • toothpaste / dental floss

  • SHAMPOO/ BODY WASH / SOAP / SOAP DISH

  • SMALL SHOWER BASKET FOR CARRYING TOILETRIES

  • COMB/HAIR BRUSH

  • HAIR BANDS/ ELASTICS FOR 1 WEEK

  • FLASHLIGHT

  • BUG REPELLENT

  • SUNSCREEN

  • RAIN COAT / UMBRELLA

  • LAUNDRY BAG

  • BACKPACK