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 5. Educational Qualifications 6. Name of School/College/Deptt. 7. Fathers 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 Page 4) Age:

10. Achievements in Sports for last 1 year, if any (Documentary proof in support to be attached)

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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

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-: 3 :RULES AND REGULATIONS 1. SAI/AITA will not be responsible for any injury/loss of life during the playing period and no compensation or claim will be entertained. 2. All instructions imposed by the Administrator or his representative will be strictly adhered to. 3. Membership Card will be brought every day and will be shown on demand from Authorized Officer. 4. Pets are not allowed inside the Stadia Complex. 5. Any deliberate damage/loss caused to the Stadia property will be recovered from the member. 6. 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. 7. The access to the family members is limited to areas mentioned on the Card. 8. SAI/AITA will not be responsible for loss of any valuable/cash. 9. Fee will be collected a week before the month from members between 10 AM to 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 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)

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-: 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)

VOLLEYBALL,

I.G. STADIUM

BADMINTON, BASKETBALL, BOXING, CYCLING, GYMNASTICS, JUDO, TABLE TENNIS & WRESTLING (Tel: 011-23392729) CRICKET & HOCKEY (Tel: 011-2338 9740) SWIMMING (Tel: 011-2309 4832)

MAJOR DHYAN CHAND NATIONAL STADIUM DR. SHYAM PRASAD MUKHERJEE SWIMMING POOL COMPLEX DR. KARNI SINGH SHOOTING RANGES R.K. KHANNA STADIUM AFRICA AVENUE New Delhi-110029

SHOOTING (RIFLE, PISTOL & SHOT GUN) (Tel: 011-2604 7802) TENNIS (Selection through Competitions ) (Tel: 011-2617 6279)

Details can be had from sportsauthorityofindia@nic.in and AITA website)