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Mystic Voyage: 1 Adventure Trekking Camping Course-2015

The document is an application form for the 1st Adventure Trekking Camping Course organized by Mystic Voyage from February 25th to March 1st, 2015. The trekking route is from Phaparkheti to Lakethang to Lilakha and ends at the Doley Camp in the Neora Valley National Park. The application asks for personal details like name, address, contact information, education/occupation, previous adventure experience, food preferences, outdoor activity interests, and medical details like blood group and allergies. Applicants and guardians must sign declarations agreeing not to hold the organization responsible in case of any accidents.

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Rajeev Singh
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42 views1 page

Mystic Voyage: 1 Adventure Trekking Camping Course-2015

The document is an application form for the 1st Adventure Trekking Camping Course organized by Mystic Voyage from February 25th to March 1st, 2015. The trekking route is from Phaparkheti to Lakethang to Lilakha and ends at the Doley Camp in the Neora Valley National Park. The application asks for personal details like name, address, contact information, education/occupation, previous adventure experience, food preferences, outdoor activity interests, and medical details like blood group and allergies. Applicants and guardians must sign declarations agreeing not to hold the organization responsible in case of any accidents.

Uploaded by

Rajeev Singh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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1st ADVENTURE TREKKING CAMPING COURSE- 2015

Route: Phaparkheti Lakethang Lilakha - Doley Camp in Neora Valley National Park
From: 25th Feb. 1st March, 2014

Organised by

Mystic Voyage
APPLICATION FORM
1.

NAME (in block letter)

2.

GUARDIANS NAME

3.

PRESENT / PERMANENT ADDRESS

4.

MOBILE NO. & Email

5.

DATE OF BIRTH (age)

6.

EDUCATIONAL QUALIFICATION / OCCUPATION

7.

NAME & ADDRESS OF THE INSTITUTION /OFFICE

8.

PREVIOUS EXPERIENCED IN ANY ADVENTURE


COURSE? DESCRIBE

WHETHER A MEMBER OF ANY OTHER


ORGANISATION / ADVENTURE CLUB

10.

FOOD HABIT (veg / non veg)

11.

OUTDOOR ACTIVITIES
(Mountaineering/Trekking/Rock Climbing/Camping etc)

BLOOD GROUP & ANY HISTORY OF ALLERGY

9.

12.

) VE

I shall abide by the rules and regulations of the organization and Adventure Trekking Camping Course 2015 and will maintain perfect
discipline. In case of any injury, accident or any unforeseen eventualities, I will not hold any member or the Foundation wholly or
partially responsible in anyway.
Date:
Signature of the Applicant
DECLARATION OF GUARDIAN
(FOR BELOW 18 YRS. AGE PARTICIPANT)
I am allowing my Son / Daughter Sri/Smt . to
attend the Adventure Trekking Camping Course 2015. In case of any injury, accident or any unforeseen eventualities of my Son /
Daughter, I will not hold any member or the Foundation wholly or partially responsible in anyway.
Date:
Signature of the Guardian

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