1

Appendix ‘ B ’
(Refers to Para 14 of AJI)
NOMINAL ROLL OF NCC CADETS FOR ATC-08
FROM 04 May 2024 to 13 May 2024

S Regtl Ran k Name Date Father/ Institution Veg/ Belonging to

No No of Birt Guardi Name No n- Govt/Gov t
h an Veg Aided/Sel f
Name Financin g
with full Institution
Address
and
Mob No.

(Signature OC Unit with Seal)

 2

Appendix ‘ C ’
(Refers to Para 14 of AJI)

RISK CERTIFICATE /FORM FOR WILLINGNESS CERTIFICATE

This is to certify that, I No-------------, Rank------------Name-----------------------------------------

S/O…………………………… College/School -----------------------------------------------------------------

Volunteer to undergo Camp/Course …………………………………………………………….

to be held at ------------------------------------------------------------------------------------------------------

from …………………to……………………… on my own risk.

Signature of Officer/Cadet

Countersigned by OC Unit

CONSENT OF PARENT/GUARDIAN CERTIFICATE

This is certified that I have no objection to spare my son/Daughter .No……………………

Rank………………………Name………………………………….of…………………………

……………………………………………………………………………………………………..

to attend the …………………………………………………………………………………….

to be held at …………………………………………………...................................................

from………………………………to…………………………………………..

Signature……………………………
Name in BLOCK LETTTERS
Address………………………………….
…………………………………...
…………………………………..
……………………………………
……………………………………

Countersigned by OC Unit
 3
Appendix ‘ D ’
(Refers to Para 14 of AJI)

FORM OF IDEMNITY BOND

In consideration of my being nominated it my request to under go all types of trig and

also participate in any camp/course/adventure training activities in/outside NCC and traveling.
Administration will make claim against the Government of India or against any person in Service
of the Government of India in respect of any loss or injury to the property or person (including
injury resulting in death) Which I may suffer while or in consequence of may being in
training/participation in camp/course. Adventure training activities in/out side NCC and traveling
and understand that no compensation will be paid by the Government of India of any Officer,
JCO/OR. Armed Forces/civilian MT Driver or against any person injury (including injury
resulting death) and I agree so as to bind any officer, JCO/OR. Armed Forces/civilian MT Driver
and any person in the Service of Government of India any claim which may be made by any
third party against them or any of them arising our act of default on my part which may be made
by any third party against them or any of them arising our act of default on my part during or in
connection of said training/camp/course, adventure training and injury by road/rail/bus/river and
flight.

The Government has agrees to bear the stamp duty on this account.

Signed by the Applicant Signature of Applicant

No. Rank and Name
Sri…………………………….. Address and Designation……………
In the presence of

WITNESS
1.Signature: ………………………
(With date)
Name in BLOCK Capital letters……………………………………..
Address

2.Signature: ……………………. Countersignature of Father or Guardian

(With date) (With date)
Name in BLOCK Capital letter
……………………………………… Name in BLOCK capital
Address…………………………….. Address……………………

Station:
Date :

COUNTERSIGNED BY OC UNIT
 4

Appendix ‘ F ’
(Refers to Para 14 of AJI)

FORM FOR MEDICAL FITNESS CERTIFICATE

1. Certified that I have examined No……………Rank…………Name………………

S/O……………………………College/School……………………………………………………….
………………………………………………………………..and found him fit/unfit in accordance
with of NCC Training Whenever detailed.

2. I also certify that the above Officer/Cadet has been inoculated/vaccinated against , COVID-
19, Small Pox, Cholera, Typhoid Fever and Tetanus

Signature of Medical Officer……………………………..

Name……………………………………………………..
Designation………………………………………………

Station……………………………..
Date……………………………….. (Seal)
 5

Appendix ‘ G ’
(Refers to Para 14 of AJI)

DROWNING /ACCIDENT CERTIFICATE

1. I know that there is deep water near the camp site, en route and the area of the
water is out of bound, If I go there I shall do so at my own risk.

2. I have been explained the orders regarding precautions to be taken against drowning
accident and have understood them. I have been told not to go near deep water in the
vicinity by the in/charge. If I go any one of these out of bond area, I shall do so at my
own risk..

Signature of the Cadet ___________________

No._________ _____Rank________________
Name :_________________________________

ATTESTED BY PRINCIPAL/HEADMASTER OF THE INSTITUTION

1. Certified that the above named Officer/Cadet is on the roll of the College and can be
Spared for the Camp.

2. Certified that I have explained the order regarding precautions to be taken against
Drowning accident.

Station: Signature of Head of Institution

Dated: Seal:

Countersignature of OC Unit