8th Open Saurashtra Roller Skating & One Hour Non Stop Skating

Championship-2021
ENTRY FORM – 1 HOUR NON-STOP SKATING
Date : 27th February, 2021
Organized by : Pratyusha Skating Academy & Shree Swaminarayan Gurukul
Specialities of this event.............Every Participant will get
Form No. ________ MEDALS & CERTIFICATE
ENTRY FEES RS. 500/- Reporting Timing : 4:30 pm
Tenacity Quad Inline Tournament Timing : 5:00 pm To 6:00 pm
After the Game Prize Distribution will be held

Amit Pandya Saumya Chauhan Jalpa Pandya Kripalsinh Talatiya

Gurukul Skating Club Pratyusha Skating Academy Pratyusha Skating Academy Sunshine School
Pratyusha Skating Academy 94093 23259 8000008841 8460852883
Rajkot .8000008842

Instruction:
1. Wearing of Helmet & Skating are Compulsory.
2. Last Date of submitting the Entry Forms is 25thJanuary,2021, Thursday.
3. The decision of the Organization Committee is Final & Binding to all Skaters.
4. Injuries are part and parcel of any sport activity and although all particular care and attention would be the
participants, Organization or any other coach or body associated with the event will not be responsible for any
injuries that may take place during the event.
5. Registration can be done at Shree Swaminarayan Gurukul Dhebar Road, Rajkot [5:00 pm to 7:00 pm]
Pratyusha Academy,Yoginagar Society, Block No.51, B/h. Akashwani Quarter, Uni.Road, Rajkot.
[ 4:30 pm to 11:00 pm].
6. Prize Distribution for this eventon Saturday 27th February, 2021 Time : 6:30 pm.
7. Tournament Fees are non refundable
8. Venue : Shree Swaminarayan Gurukul, Gondal Road, Rajkot.
...............................................................................................................................................................................................
NOTE : ENTRY FORM SHOULD BE FILLED IN CAPITAL LETTERS ONLY
Form No. __________ Name of District :
Name(In Capital Letters Only) :
Sex : Male Female
Address :

DOB(DD/MM/YY) : Age Group :

School’s/ Club’s Name :
Parent’s Contact No :
Coach’s Name : Coach’s Contact No. :

Tenacity Quad Inline Tournament Timing : 5:00 pm To 6:00 pm

Injuries are part and parcel of any sport activity and although all particular care and attention would be the participants,
Organization or any other coach or body associated with the event will not be responsible for any injuries that may take
place during the event.
I the undersigned hereby declare that above Information is true to the best of my knowledge and the participating in the
above mentioned championship at my own cost & risk. I shall not hold the organizers responsible for injuries/damages.

Date : Signature of Parent :