SPORTS AUTHORITY OF INDIA JAWAHARLAL NEHRU STADIUM COMPLEX (EAST GATE) LODHI ROAD, NEW DELHI-110 003
Application Form for admission under “COME & PLAY SCHEME” Please attach two passport size photographs
1. Name 2. Address 3. Telephone No. 4. Date of Birth
Age:
5. Educational Qualifications 6. Name of School/College/Deptt. 7. Father’s Name & Occupation 8. Sports/Games applied for (Please write the name of Discipline) Or Tick (√ ) mark under Athletics, Badminton, Basketball, Boxing, Cricket, Cycling, Football, Gymnastics, Hockey, Judo, Shooting, Swimming, Table Tennis, Tennis, Volleyball, Weightlifting & Wrestling. 9. Stadia applied for
J.N. Stadium / I.G. Stadium, including K.D. Jadhav Wrestling Stadium and Cycling Velodrome / Major Dhyan Chand National Stadium / Dr. Shyama Prasad Mukherjee Swimming Pool Complex / Dr. Karni Singh Shooting Ranges / R.K. Khanna Stadium, New Delhi (See (See Page 4)
10. Achievements in Sports for last 1 year, if any (Documentary proof in support to be b e attached)
Contd…2/-
-: 2 :-
11. Any other information you think relevant for considering your application …………………………………………………………. 12. Mandatory requirements: (a) Shooting
Copy of the Arms Licence (except for Air Rifle & Air Pistol)
(b) Other disciplines Copy of the Medical Fitness Certificates [Documentary proof in support of (a) & (b) to be attached]
I declare that the information given above is correct and undertake to abide by the rules and regulations laid down / that may be laid down.
Approved for issue of Card (Signature of applicant)
Recommendation of Coach
Signature, Name & Stamp of Head of Institute / School / Department or Identity Proof Date ………………………. Stadia Administrator
Contd…3/-
-: 3 :RULES AND REGULATIONS 1. 2. 3. 4. 5. 6.
7. 8. 9.
SAI/AITA will not be responsible for any injury/loss of life during the playing period and no compensation or claim will be entertained. All instructions instructions imposed by the Administrator or his representative representative will be strictly adhered to. Membership Card will be brought every every day and will be shown on demand from Authorized Officer. Pets are not allowed inside the Stadia Complex. Any deliberate deliberate damage/loss damage/loss caused to the Stadia property will will be recovered from the member. mem ber. Stadia Authority reserves the right to suspend/cancel the membership of any individual without giving any prior notice/reason in the interest of efficient functioning of the arrangements. The access to the family members is limited limited to areas mentioned on the Card. SAI/AITA will not be responsible for loss of any any valuable/cash. Fee will be collected a week before the month from from members
between 10 AM to 2PM. 2PM. The cards automatically get cancelled, if not renewed within stipulated period. 10. No refund or adjustment of fee will be made in case the Swimming Pool & other facilities are closed for maintenance or for any other unavoidable reasons. 11. Documents required for membership: Two passport passport size photographs, Residential Proof or Identity Proof, Date of Birth Certificate & Medical Fitness Certificate and also the applicant should not suffer from any contagious disease. 12. SAI/AITA reserves the right to change the Training time as and when required.
I have read the above rules and regulations and hereby undertake to abide by them.
(Signature of the applicant)
(Signature of guardian)
Contd…4/-
-: 4 :(FOR OFFICE USE ONLY) Received a sum of Rs.………… (Rupees ………………………………… only) towards registration/membership fee for the quarter ending …………………………………………… vide Receipt No. ………………… dated …………………… Card No. …………………. issued/renewed on ………………………….. valid upto ……………………………
Office of the Administrator (………………………………….)
PS:
STADIA-WISE DISCIPLINES
J.N. STADIUM
ATHLETICS, FOOTBALL, WEIGHTLIFTING, (Tel: 011-24369781)
I.G. STADIUM
BADMINTON, BASKETBALL, BOXING, CYCLING, GYMNASTICS, JUDO, TABLE TENNIS & WRESTLING (Tel: 011-23392729)
MAJOR DHYAN CHAND NATIONAL STADIUM
CRICKET & HOCKEY (Tel: 011-2338 9740)
DR. SHYAM PRASAD MUKHERJEE SWIMMING POOL COMPLEX
SWIMMING (Tel: 011-2309 4832)
DR. KARNI SINGH SHOOTING RANGES
SHOOTING (RIFLE, PISTOL & SHOT GUN) (Tel: 011-2604 7802)
R.K. KHANNA STADIUM AFRICA AVENUE New Delhi-110029
TENNIS ( S e le c t i on t h r ou g h C om p e t i t i on s ) (Tel: 011-2617 6279)
Details can be had from
[email protected] and
[email protected] and AITA website)
VOLLEYBALL,
