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Outdoor Adventures & Environment Institute, Indore, India |
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Please take the printout of this form and deposit it at our office of at meeting place
Enrolment Form Form No..........................................
Introducer........................................
Yes , I would like to be the member of Outdoor Adventures & Environment Institute, Indore.
I have read the rules & regulations of the Institute for the membership and agree to abide by the same.
Name: Mr./ Mrs./Miss..............................................................................................................................
Address : ...................................................................................................................................................
..................................................................City :...................... , Pin........................ Tel (O)......................
Tel (R).............................., Mobile........................................ Male Female
E-mail:
Date of Birth....../......./.......... Blood group.........
Membership Subscription: (tick any One)
Individual: One Year Rs 100 /- Family One year Rs 200 /-
Two Year Rs 150 /- Two year Rs 350 /-
Life Rs 2000 /-
Company / Corporate Rs 2000 /- (One Year)
Schools / Institutions / Social Club Rs 1000/- (One Year)
Registration is Rs/- 50/-
Kindly find enclosed cash / Cheque / DD. No............................. dated.........................drawn on.........................................
for Rs....................................towards membership fee for the year......................
I assure that the above particulars are true to the best of my knowledge. I allow myself / My Son / Daughter / Ward / Mr. / Mrs. / Miss .............................................................for any institute activity on my own risk and no compensation will be paid to me or my ward in case of any accident / injury and I will not hold the Institute or it’s staff wholly or partially responsible for any mishappening.
(Signature of Applicant) (Signature of Parent / Guardian / Applicant)
( Note : Below 18 years of age is to signed by Parents / Guardian.)
...........................................................................................................................................................................................
Received with thanks from Mr. / Mrs. / Miss .................................................... for rupees....................... for the membership of ............................. on dated............................ for the year........./........./........
Date: ......./....../....... For OAEI - Authorized Signature
Other Details :-
For Individual
Occupation: Student Service Business Housewife Others
Camp Life Experience (if Any) .................................................................................................................. ........................................................................................................................................................................
Other Hobbies : Traveling Painting Model making Sculpture
Photography Collection (please specify)......................................Others...........................
Which Adventure you like :
Rock Climbing | Absailing | Zumaring | Trekking | Astronomy | Birds Watching | Water Sports | Para Sports | Mountaineering | Skiing | Himalayan Trekking | Environment Preservation Programms | any other............
For Company / Corporate / Schools / Institutions
I allow our Students / Staff / Members of (Name)...........................................................................for any institute activity on my own risk and no compensation will be paid to me or my Institute / Company / club in case of any accident / injury and I will not hold the Institute or it’s staff wholly or partially responsible for any mishappening.
For and on behalf of..........................................................................
Authorized Signatory Name of the person............................................................
(Please mark the stamp)
Designation.........................................................................
.........................................................................................................................................................................
Rules & Regulations :-
2. All members have to follow strict discipline. Alcohol, Smocking is strictly prohibited during camps. No vulgarity / abusing thing is allowed. Nuisance craters will be debarred from the institute and deposits will be forfeited.
3. Camp / Group Leaders has the rights to take any action against any participants who makes any indiscipline action.
4. Environment Preservation should be kept in mind during any camp.
5. The activities without Safety measure is not allowed.
6. Safety of the equipments will be the prime responsibility of the user. In case of any damage or loss, the replacement cost of the equipment will be recovered from the user.
7. All the activities organized from time to time for the members will entirely be at the member's own risk and cost. The institute will not be, in any way, responsible for any injury or any misshapenness.
8 . Others as per the By-Laws of the Institution.
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For Registration please do the following action:-
(a) Send the Personal Information by e-mail to mmel@mantrafreenet.com;rakesh_jain_22@yahoo.com
(b) Please printout this form and send it to
Er. Rakesh K. Jain (Hon. Secretary)
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Office :- 308, Chetak Centre, 12/2, R.N.T. Marg
Near Hotel Shrimaya, Indore - 452001, M.P. (India)
Tel: 91 731 2527224 , 94250 77008
Gear Satore:- "Press
House", 22, Press Complex,
A.B. Road, Indore -452001 ( M.P.) , India
E-Mail: outdoor4u@rediffmail.com ;rakesh_jain_22@yahoo.com
e-group : outdoor_adventures-subscribe@yahoogroups.com
Yahoo Messenger : adventure_indore