Aarambh Adventures trekking club

Registration form

Participant’s name :

Date of birth : age: Passport size

photo with sign
Father’s name :

Address :

Contact no:

College name with address :

Emergency contact no (other than mentioned above) :

E-mail ID :

Are you a part of NCC/ scout and guide or any other adventure group?:

Medical details
Height : weight: blood group :

Any allergy :

History of any disease :

Declaration form
I declare that the information given in this form is, to best of my knowledge, complete and
correct. I understand that any wil-ful mis-statement renders me liable to disqualification or
dismissal if engaged.
Date :
signature

RISK CERTIFICATE

It is certified that I agree to detain my ward/myself

____________________________ son/daughter of ________________________ for
taking part adventure activities of Aarambh adventures club at my own risk and no
compensation will be paid to me in case of any accident/injury or any loss/damage, I will
not hold the Club or its members wholly or partially responsible for any mishappening.

Place:__________

Date : __________ Signature of Applicant & Parent /Team Manager