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INDIAN RURAL OLYMPIC ASSOCIATION INDIAN RURAL OLYMPIC ASSOCIATION INDIAN RURAL OLYMPIC ASSOCIATION (Registered Under Indian Society Registration Act, 1860) 1. Name of the Player: ...................................................................................................... 2. Father's Name: ................................................................................................................ 3. Mother's Name: ............................................................................................................... 4. Date of Birth: .......................,........................................................................................... 5. Age as on 31/12/2017: .....................Yrs....................Months: .....................Days 6. Address: ......................................................................................................................................................................... . ............................................................................................................................... Pin Code: ........................................ 7. E-mail: ......................................................................................... Phone No.: ............................................................ 8. Name of School/College/Institute (if any): ....................................................................................................... . ................................................................................................................................ Pin Code: ....................................... 9. Class: ..............................Roll No.: ..........................Registration/Admission No.: ............................................ Declaration: I hereby declare that the information given in this registration form are true and correct. My registration will be cancelled if anything found incorrect. As per rule fees is also not refundable. Signature of Player State:................................................ Game: ........................................... *Reg. No. INWROG/17/................ Age Group: Under ....................... Category: Boys/Girls/Mix Track-Suit Size: 38/40/42/44 Website: www.ruralolympic.org E-mail: [email protected] Registration Form Indo-Nepal Winter Rural Olympic Games To be illed in Capital letter/बड़े अर म भरे िखलाडी का नाम िपताजी का नाम माता का नाम जमितिथ ३१/१२/२०१७ को आयु पाचार का पता ई-मले एसे कल/कॉलजे /शिे क संथान का नाम (यिद पढ़ते है ) ू का रोल नंबर पंजीकरण/दािखला संया म घोषणा करता हँ क मरे े ारा इस फाम म दी गई समत जानकारी एकदम सही और सय ह|ै अगर िकसी कार क कोई गलती/टी पाई जाती हैतो मरे ा पंजीकरण र कर िदया जाय|े िनयमानसार मझेफस वािपस नह िमलगे ी| ु ु ु Approval By State Secretary I, hereby declare that I have personally check all the detail of this Player and found everything correct. I approve Mr . ........................................................ for this National/South Asian/International Championship Stamp and Signature Secretary Name ................................................. Phone No. ......................................... *रिजशे न नंबर ऑिफस ारा भरा जाएंगा|Registration No. will be filled by office PAST HERE PASSPORT SIZE PHOTOGRAPH OF PLAYER

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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:[email protected]

Registration Form Indo-Nepal Winter Rural Olympic Games

TobeilledinCapitalletter/

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

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

* |Registration No. will be filled by office

PAST HEREPASSPORT SIZEPHOTOGRAPH

OF PLAYER

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