Hindi Classes

HindiUSA Chesterfield Chapter

9 Recklesstown Way, Crosswicks, NJ
08080
(Non Profit Volunteer Organization)
Phone: (609)-617-1124 Web: www.hindiusa.org
E-mail: chesterfield@hindiusa.org
Contact: Shipra Sood

Hindi Classes held every Friday, from 7-8:15 P.M. from

September thru June at Chesterfield Elementary School, 295
Bordentown-Chesterfield Road, Chesterfield, NJ 08515
æ Hindi classes in 9 levels, Ages 5-16
æ Total fee of $250 ($225 if register by August 15) for the whole year (includes books and
materials). Siblings get $50 discount. All text books are given at the time of registration.
æ Classes start on September 10, 2010, and will run thru June 2011
æ Students will learn reading, writing, and speaking in Hindi through attractive books,
software, and curriculum
æ Students will have a chance to participate in Hindi Mahotsav (largest annual Hindi program
in North America)
æ Students will receive certificates for passing Hindi examination
æ Students are taught by experienced teachers
Register ASAP! Class sizes are limited!! To register, mail the
below form to the address given above with a check of $250
(payable to HindiUSA). Registration form can also be
HindiUSA is looking for volunteers and Hindi teachers. If you are interested, please call
1-877-HINDIUSA

Student’s Name ______________________________________________________

Student’s name in Hindi (optional) __________________________________
Date of Birth: ______________ Age: _______ Gender: M / F
Current Level of Hindi: ____ Parent’s/Guardian’s Name __________________________
Address ______________________________________________________________
Phone (Daytime) ____________________ Phone (Evening) _____________________
Parent’s/Guardian’s E-mail ___________________________________________
Mother Tongue __________________________

CONSENT: I, the undersigned, state that I am the parent and/or legal guardian of the student named above. If
my child is found to be disruptive in the Hindi class by the classroom teacher(s), I accept his/her dismissal from
the classroom for the rest of the school year. Classroom teacher(s) decision is final and I agree to abide by that
decision. I also accept liability for any material damage caused by my child’s behavior in school. I accept that
there will be no fee refunds, if my child voluntarily drops out of classes during the school year for any reason, or
is dismissed.

I/WE, on behalf of ourselves and ____________________________________(child/children's name) do hereby

agree to hold HindiUSA a non-profit organization, and its representatives, staff and members, volunteers, paid or
unpaid, harmless from any responsibility or liability, any and all bodily injury and illness claims, demands,
damages, costs, expense actions and cause of action arising from any act or occurrence while attending
HindiUSA classes or as a result of participation in the programs and activities conducted under the auspices of
HindiUSA. I/We agree to indemnify HindiUSA and its representatives, staff and members for any costs or
liabilities which they may incur as a result of our or our child's participation in any of its programs. Furthermore,
I/We waive any liabilities that HindiUSA and its members may have to me and my said child/children as a result
of any injury, illness, or property damage while participating in their programs. I/We fully understand and assume
full responsibility for our and our said child/children's actions while entering into this arrangement with HindiUSA.

Signature (Parent/Guardian): _________________________ Date: ______________