SKATER ANNUAL REGISTRATION 2019-20

SKATER REGISTRATION FORM

Registering State : Maharashtra
Registering District : Thane
Registering Club : RAISA, Sri Ma Gurukul, Thane
Discipline : Speed-Inline
Other Discipline : NA
Application No :31514
Date : 2019-09-18 17:05:10

Name : Abhyang Varad Pradhan

Date of Birth : 28-02-2010

Age :9

Age Group : 9 to 11 - Cadet (as on 31-12-2019)

Gender : Male
Fee : Rs. 250/-
Blood Group : O+ve Payment
: Success
Status
Phone & Email : 9930395886 | varadpradhan@yahoo.com
Order ID : 31514
Res. Address : A-103, Bhakti Park, Phase-2, Anand Nagar, Thane 400615 Tracking ID : 108668980216
Mode : Net Banking
Res. District : Thane
: 18/09/2019
Date
Res. State : Maharashtra 17:05:45
Declaration
I hereby declare that
1. I am / was not a registered skater with a State / U.T Unit other than the present one.
2. As I am aware that only the Roller Skating Federation of India (RSFI) registered skaters are allowed to participate in Internationals, Asians and RSFI approved National –
All India – Memorial – Invitational Tournaments and the State / U.T Units approved State-District & Other local championship, hence I undertake not to participate in any
competition & / or championship which does not have approval of RSFI & State /U.T. Unit as mentioned above.
3. I have attached the proof of identity , Address and date of birth as per RSFI guidelines and I will produce necessary original documents whenever
asked by RSFI/State Association/District Association.
4. I understand that completing online registration and making fee payment does not mean the completion of registration process. My registration is subject to approval of
District & State Units and RSFI.
5. I accept to share the information provided by me to RSFI and any service providers associated with RSFI.
6. I accept to receive newsletters / any communications from RSFI in a form of mail, email, phone call, SMS.
7. All the information entered in the online registration system (as furnished above) are true and I am responsible for the correctness of the information provided.
8. I will accept any decision taken by RSFI if any of the information given above found wrong and the fee paid will be forfeited. RSFI holds all the rights to reject or cancel
the registration of the skater anytime.
9. I will produce all the original documents and supporting documents whenever necessarily asked by RSFI/State Association/District Association. I undertake to abide by all
the rules and regulations issued from time to time by RSFI/State Association/District Association.
10. I / My ward am/is aware that Rules and regulations are subject to change.
11. I hereby declare that all the information furnished by me is true and correct to the best of my knowledge and belief.
12. I undertake that I shall not drag the name of the Game & Championship in any adverse manner either on Social Media or in the print media.
13. I shall not oppose any decision taken in the view of betterment of the Game as well as Championship by my coach/ manager/ Organizing committee/ District/ State/
Federation.
14. I also undertake that I shall not cause any harm / damage to the reputation of the Game (Championship)/Players/Officials/Spectators and further undertake not to cause
any damage to the property during the Championship.
15. I hereby undertake that I shall abide by all the Rules & Regulations laid by the Championship committee for the smooth functioning and management of the
Championship and if I fail to do so, I would accept the action taken by District/State Association/Organizing Committee/Coach/Manager/Federation.
16. I / I on behalf of my ward undertake that I/ My ward shall not participate in any event organized other than C.B.S.E ,K.V.S , SGFI. Govt. Organization or any other event
organized by OUR RSFI STATE ASSOCIATION, DISTRICT ASSOCIATION & Roller Skating Federation of India. In case of breach of this undertaking RSFI/State
Association/District Association will be free to take appropriate Steps.
17. I / I on behalf of my ward undertake that for any injury/loss of any nature what so ever caused to me/my ward during the camp/championship in India, on or off the
playing area or during the journey, RSFI/its members/officials and or its State/U.T / District Units and its officials shall not be responsible and or liable to meet any
expenses/damages whatsoever.
18. I / I on behalf of my ward shall take adequate accidental, medical, life insurance policies as they deem fit and at the beginning of the said
tour/Championship/Tournament/Camp etc.
19. As i am aware that my / my ward's registration is subject to the approval of the District/ State / U.T Unit, so that i will submit the Form and documents to the
Club/District/State unit as soon as possible.
20. I/My Ward hereby confirm and declare that I/My Ward have/has not taken part in any Championship/Tournament held during 2018-19 which did not have the approval of
RSFI/State/District Unit.
21. I/ I on behalf of My Ward declare that I/My ward shall not hold the organizer or any person from the Federation/association responsible for any Injury / Accident to me or
my ward during practice/Championship. I also declare that I shall not claim for any damages from the organisers / any member of the Association / The association for any
incident / Injury / Accident to me or my ward.

Signature of Skater Signature of Parent/Guardian

Seal & Signature of the Club Seal & Signature of the District Association

Seal & Signature of the State Association