VAM Membership Form .pdf

File information


Original filename: VAM Membership Form.pdf
Author: Rashid

This PDF 1.5 document has been generated by Microsoft® Office Excel® 2007, and has been sent on pdf-archive.com on 24/03/2014 at 13:41, from IP address 223.225.x.x. The current document download page has been viewed 453 times.
File size: 594 KB (2 pages).
Privacy: public file


Download original PDF file


VAM Membership Form.pdf (PDF, 594 KB)


Share on social networks



Link to this file download page



Document preview


VAM/Membership Form/Page 1 of 2

Qazibagh,Opposite Oxford Presentation School Anantnag (Jammu & Kashmir) INDIA.
Email.ID
Website
Fb.ID

verticalamble@gmail.com
www.verticalamble.in
www.facebook.com/Verticalamble

Form No:

Section 1: Personal Details (please complete in capital letters)
Name
Parentage
Address

Present Address
D

D

M

M

Y

Y

Y

Y

Date of Birth
Blood Group
Qualification
Cell No:
Email Address
Home Contact No.
Any other personal
information which is of
benefit to the
Mountaineering Club:

I solemnly affirm that the above information is
true.

Signature of intending member

FOR OFFICIAL USE ONLY
Membership fee Rs.500/- Paid vide receipt No___________
Dated__________________
Member Registration No________________
Membership: Temperory / Permanent
Membership period________________

Paste here your
recent color
photograph

VAM/Membership Form/Page 2 of 2

VERTICAL AMBLE

mountaineering

Section 2: Declaration (put an affirmative √ or negative x in the boxes as appropriate)
I recognize that climbing and mountaineering are activities with a danger of personal injury or death. I am
aware of and accept these risks and will be responsible for my own actions and involvement.

I agree to this form being kept indefinitely by the Vertical Amble Mountaineering, on the
understanding that the disclosed information will be kept confidential and shared only between the Club's
committee. Other than the Club or where required in consultation, the information on this form will not be
I solemnly confirm that i will maintain the utmost discipline during clubs activities/ meeting and will abide
with the constitution of club.

Section 3: Medical Information (put an affirmative √ or negative x in the boxes as appropriate)
I do not have a medical condition which may limit or prevent full and safe participation in club activities

I do agree to bring medication to any club session where it will be required.

I will inform the club president if the circumstances change over the course of time.

Before each club activity, I will inform relevant members of the committee of any medication, allergies,
injuries or other medical conditions that may affect my ability to participate fully in the sport on that day.

Note (pleae attach following documents self attested):

1. D.O.B certificate.
2. Blood group certificate.
3. Permenant residence certificae.
4. Qualification certificae.

I solemnly affirm that the above information is
true.

Signature of intending member


Document preview VAM Membership Form.pdf - page 1/2

Document preview VAM Membership Form.pdf - page 2/2

Related documents


vam membership form
2016 2017 membership form
neaacccustomerbrochure
bp info consent and health form
outdoortripinfoandforms1
applicat revealing the gold2018

Link to this page


Permanent link

Use the permanent link to the download page to share your document on Facebook, Twitter, LinkedIn, or directly with a contact by e-Mail, Messenger, Whatsapp, Line..

Short link

Use the short link to share your document on Twitter or by text message (SMS)

HTML Code

Copy the following HTML code to share your document on a Website or Blog

QR Code

QR Code link to PDF file VAM Membership Form.pdf