Interim Secretary

Entry Form
Saraswati Rajput 5th National Masters Games - February 2023
2nd - 5th February 2023, Hyderabad Photo
Treasurer
B. S. Reddy (FILL IN CAPITAL LETTERS ONLY)

Patron: Name
Dr Anmol R. Sidhu Gender
(Senior Advocate)
Age group 30-34 (30+) 35-39 (35+) 40-44 (40+) 45-49 (45+)
Dr Arjun Singh Rana 50-54 (50+) 55-59 (55+) 60-64 (60+) 65 above
(Vice-Chancellor-Swarnim
Gujarat Sports University) DOB D D M M Y Y Y Y
State
Sr. Vice President District
Dr. T.V. Rao Address PIN
Contact
Vice President No.
Bharat Dangar Emergency
Manmohan Singh Contact no.
Balram TS Contact
Person
Rajvir Singh Juneja
Email
Abhay Kanoria
Games/ Archery Single
Sports Athletics Track Event Field event
Joint Secretary Category Badminton Single Double Mixed Doubles
Prashanth Ram (Please
Basketball Team Event
Balu Chavan Tick)
Cycling Single
Tajuddin Football Team Event
Jagjeevan Reddy Handball Team Event
Dinesh Kumar Hockey Team Event
Kabaddi Team Event
Legal Advisor Lawn Tennis Single Double Mixed Doubles
Shooting Single
P.K. Choudhary Swimming Freestyle Butterfly Backstroke
Table Tennis Single Double Mixed Doubles
Executive Volleyball Team Event
Members Weight Lifting
Ruby Gupta Declaration:
Anurag Rathi I/We here declare that we are in good health and in proper condition to participate in the competition. I/We absolutely relive Masters Games
Federation (MGF) organizing committee and sponsors for any responsibilities, injuries, physical loss, or damage that occurred to me or my property
Amanat Khan that may sustain in the course or in connection with the 5 th National Masters Games 2023. Masters Games Federation and all event sponsors
acknowledge that any action taken against us by the officials while performing their duties shall not give rise to any action of claims by the
Naresh Goswami concerned officials.
Rajinder Sharma
Note: January 15, 2023, is the last date for entry submission. NO SPOT ENTRY WILL BE ENTERTAINED
Kaushik Ray
Deposit all the entry fees in the below account.
Y Rama Rao
Name: Masters Games Federation
Siba Mishra Bank Name: Canara Bank
Dr. Mohd Sartaz A/C No.: 110058030714
IFSC Code: CNRB0001182
Address: 27B Rajpur Road, Dehradun

Participant State President State Secretary