S. L.MINDAMEMORIALSPORTSACADEMY

(-Project of MogaDeviMindaMemorialSchool, Bagla-)

Bagla Road, Bagla, Hisar (Haryana)

ADMISSION FORM

Name: ______

Gender: ______

Class:______

Section: ______

Father’s Name: ______

Date of Birth: (dd/mm/yy) ______

Address: ______

______

______

______

Mobile /Phone No.______

Sports Activity:

tick as applicable :-

  1. Athletics
  2. Volleyball
  3. Basketball
  4. Table Tennis
  5. Taekwondo
  6. Boxing
  7. Wushu
  8. Wrestling
  9. Kabbadi

______

Applicant’s SignatureParent/Guardian Signature

Name:Name:

------for office use ONLY ------

Admission fee: Annual /Monthly etc.______

Admission Date:______

Admission No.______

______

Authorised Signatory

Undertaking / Declaration Form

To

The President

S.L.MindaMemorialSportsAcademy

Bagla, Hisar, Haryana

I, ______S/O ______hereby undertake that I will abide by the rules and regulation of S.L.MindaMemorialSportsAcademy. I am joining the S L MindaMemorialSportsAcademy, Bagla voluntarily and I am medically fit to participate in the sports activities of the SLMSA.

(IN CASE OF A MINOR APPLICANT)

I, ______Parent/Guardian of ______Class ______Section___

declare that my child is under 18 years andI am voluntarily registering my child to SLMSA. I have read and understood the rules and regulations, as amended from time to time, and undertake to abide them.

Furthermore, I also undertake to abide by the following rules:

  1. Any student/person above the age of 8 years may apply for sports membership in the desired format provided by the Academy. However, such applications by children below 18 years will be submitted along with an undertaking by the parents/guardians of such applicant.
  2. Every student/person will have to provide age and residence proof along with a medical fitness certificate from a qualified and registered Medical Doctor.
  3. The applicant should provide 5 passport size photographs along with the application.
  4. Sports person/student/member will be required to be in the prescribed sports uniform. Sports wear, sports kit will be the responsibility of the student/member.
  5. Mere Sports Membership to the SportsAcademy does not provide any right to a member to participate in any competition.
  6. Members have to attend the SportsAcademy regularly at such time as may be prescribed from time to time.
  7. Students/members of the sports academy will arrange for their own conveyance.
  8. Students/members not following the rules and regulations may attract disciplinary proceedings including cancellation of membership and fine.
  9. Any deliberate damage caused to Sports equipment, aids, infrastructure and its facilities may attract disciplinary proceedings including cancellation of membership.
  10. In case of any injury during sports, practice session or sports competition only First Aid Facilities will be provided at the SportsAcademy.
  11. The SLMM Sports Academy, Organising Committee, office staff, coach or any members of the Committee or Sub-committee will not be held responsible for any loss, damage, accident caused either during sports activities, practice session or sports competition etc. to any sports person/member.Moreover, MDMMS or any of its staff members, teachers, and coaches will not be responsible for any medical treatment expenses or other ancillary expenses.

Signature of sports person______Signature of Parent / Guardian______

Name______Name: ______

Address______Address: ______

______

______

______

Phone/Mobile-______Phone/Mobile______