Full Name



Mobile Number

Number of people:
Adult Yuvashakthi

Children SeniorCitizen

How Many days you want: Day1 Day2 

Would like to avail accomodation at Puja Venue: Yes No 

Would like to avail the transportation facility: Yes No 

Did you pay the registration fee: Yes No 

If Yes, Mode of Payment: Bank/cheque At venue Online Payment 

Details of the payment: Cheque number, Order number etc