We Love India. We love SVJCT Entry Form Name of Participant:__________________________________________________________________________ Address:____________________________________________________________________________________ ___________________________________________________________________________________________ Name of School/Club:_________________________________________________________________________ School/Club Address:__________________________________________________________________________ ___________________________________________________________________________________________ Gender:______ (M/F) Birth Date:____/____/_____ (DD/MM/YYYY) Age:____ Yrs ____ Months Contact Number:______________ Alternate Contact Number (In case of Emergency):_____________ e-mail Id:____________________________________________________ Sporting Events (Please Tick on the event of participation) Individual Events Team Events o 100 m. Running o Shot Put o Kabaddi o Kho-Kho o 400 m. Running o Discuss Throw o Foot Ball o Basket Ball o 800 m. Running o Long Jump o Volley Ball o 4X100 m. Relay o 1500 m. Running o High Jump o 100 m. Hurdles o Wall Climbing o Table Tennis o Badminton o Archery o Shooting o Challenge Course o Swimming 50 m. Free o Swimming 50 m. Back Style Stroke Declaration I hereby agree that the organizers shall not be responsible for any accident, injury, death, loss or damages due to participation in the Sports Event organized by SVJCT Sports Academy. I also hereby, self certify that I am medically fit to participate in the Sports Event organized by SVJCT Sports Academy. I agree to all the terms and conditions for the Sports Event organized by SVJCT Sports Academy. Enclosed a)Photo Id Proof:_____________________________b) Age Proof:______________________________ c) 2 Copies of latest Photographs Signature of Participant:___________________ Official Use Id Proofs Verified By:____________________________________Registration No:_________________________ Fees Received:_________________________________________ For SVJCT Sports Academy
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