INDIAN RURAL OLYMPIC ASSOCIATIONINDIAN RURAL OLYMPIC ASSOCIATIONINDIAN RURAL OLYMPIC ASSOCIATION(RegisteredUnderIndianSocietyRegistrationAct,1860)

1.NameofthePlayer:......................................................................................................

2.Father'sName:................................................................................................................

3.Mother'sName:...............................................................................................................

4.DateofBirth:.......................,...........................................................................................

5.Ageason31/12/2017:.....................Yrs....................Months:.....................Days

6.Address:.........................................................................................................................................................................................................................................................................................................PinCode:........................................

7.E-mail:.........................................................................................PhoneNo.:............................................................

8.NameofSchool/College/Institute(ifany):........................................................................................................................................................................................................................................PinCode:.......................................

9.Class:..............................RollNo.:..........................Registration/AdmissionNo.:............................................

Declaration:Iherebydeclarethattheinformationgiveninthisregistrationformaretrueandcorrect.Myregistrationwillbecancelledifanythingfoundincorrect.Asperrulefeesisalsonotrefundable.

SignatureofPlayer

State:................................................ Game:........................................... *Reg.No.INWROG/17/................

AgeGroup:Under....................... Category:Boys/Girls/Mix Track-SuitSize:38/40/42/44

Website:www.ruralolympic.orgE-mail:ruralolympic@gmail.com

Registration Form Indo-Nepal Winter Rural Olympic Games

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ApprovalByStateSecretaryI,herebydeclarethatIhavepersonallycheckallthedetailofthisPlayerandfoundeverythingcorrect. I approve Mr. ........................................................ for this National/South Asian/InternationalChampionship

StampandSignatureSecretaryName.................................................PhoneNo..........................................

* |Registration No. will be filled by office

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OF PLAYER

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