Event Registration

First Name*

Middle Name*

Last Name*

Email-Id*

Cell No.*

Alternate Contact No.

Date of Birth*

Address 1*

Address 2

State*

City*

Pin Code*

Club / School Name*

Address 1*

Address 2

Address 3

Gender*

Age Group *

Sporting Event Category*

Event Name *

Please Make Payment Of Rs.

Payment Method*

Payment Details

Registration Fees:
Rs. 100 for Participation in Individual Event

Rs. 500 for Participation in Team event.

1.Payment can be made by Cash at the Venue, SVJCT Sports Academy, Dervan

2.Demand Draft: Addressed to ‘Shri Vithalrao Joshi Charities Trust’

3.By Online Transfer:
Account Name: Shri Vithalrao Joshi Charities Trust’s
Bank Name and Branch: Bank of India, Branch - Sawarde
A/C No.: 141110200017659
IFSC Code: BKID0001411

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.

Note - Please bring Photo ID Proof, Age Proof and 2 copies of latest photographs at the time of event.