AMITY
We Nurture Talent
AMITY SHOOTING CLUB
Amity University Campus, Sector- 125, Noida
S.No __________
Photo
+
1
1. Name Aadhyaa Gauli
___________________________________________
2. Address (Contact Tele.No) _______________________________________
___________________________________________
3. Local Guardian Address & 711/712 Building 2A Raheja Classique, Andheri West
___________________________________________
Telephone / Mobile no. +91 9136966834
___________________________________________
4. Age / Date of Birth ___________________________________________
16
5. Educational Qualifications ___________________________________________
6. Name of School / College / Deptt. _____________________ ______________________
7. Father’s Name & Occupation ___________________________________________
8. Mother’s Name ___________________________________________
8. Blood Group ___________________________________________
9. Any other information you think
Relevant for considering your application _____________________________________
I declare that information given above is correct and undertake to abide by rules and regulations laid
down/that may be laid down.
(Signature of Applicant) Mrs. Kunti Malik
Date: (Director, ASC)
For Office Use
Valid up to ………………………
Renewed up to ……………………
AMITY SHOOTING CLUB
Amity University Near - Express Way Sec-125, Noida Uttar Pradesh
INDEMNITY BOND
In consideration of my being nominated as shooter in the Amity Shooting Club (ASC) organized by Amity,
I, _____________________________________________, son / daughter of
________________________________studying in _______________________ do hereby declare that I
shall not make any kind of compensation in consequence of any mishap / loss / injury suffered by me during
such training.
I fully understand that neither my instruction staff nor Amity will be responsible to make any kind of
compensation in consequence of any mishap / loss / injury suffered by me aduring such training activity.
__________________________ ______________________________
(Signature of Student) (Signature of Parent)
Name _____________________ Name ________________________
Date ______________________ Date _________________________
Enclosures:
For Amitian 2 Colored Photographs and copy of Amity I D card.
For Non Amitian 2 Colored Photographs and copy of any I D Proof.