Camp Registration Form

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OR

Fill The Details In The Form Below. All Fields Marked With * Are Mandatory

Profile Image 300px X 400px (width X height) Max size 200 KB
Signature Image 150px X 50px (width X height) Max size 200 KB
Receipt File Image 500px X 500px (width X height) Max size 500 KB
* All the Image files should be in jpeg of jpg format

Select The Year of Camp :-

Select Camp :-

Personal Details

Select Image File *

Full Name *

Father's Name *

Gender *

Male

Female

Date of Birth

Age in Years

Marital Status *

Single

Married

Permanent Address *

Correspondance Address * same as Present Address

Mobile No *

Alternate Phone No *

Email *

Occupation *

Food *

Name of Nominee *

Nominee Relation *

Nominee Phone No *

Payment Details

Payment Mode *

Receipt/DD/Cheque No *

Payment Date *

Amount *

Select Receipt File *

Signature *

I agree to strictly abide/adhere to the discipline and the directions of the National Adventure Club (India) during the Summer Adventure Camp-2024 failing which I shall be liable for expulsion. In case of accident/injury or any loss/damage, I will not hold National Adventure Club (India or its staff, wholly or partially responsible. The above entries have been made by me and are correct to the best of my knowledge and belief. I may please be allowed to take part in the above cited/ticked game(s).