| TAG INDIA Membership Form |
I would like to join the TAG INDIA group and be a part of the group's activities. I recognize that adventure events like trekking, mountaineering, rock climbing, water sports, jungle safaris have possibility of personal injury or death. By agreeing to participate in these activities, I accept these risks and am responsible for my own actions and involvement.
I have read the group's rules and regulations and agree to be bound by it and any subsequent changes to it. If I have any medical condition or am taking any medication whilst on a club activity, I will ensure that a member of the immediate group is aware in case of an accident occurring. I have informed my next of kin of my involvement with this club, and of the precise contents of this participation statement. All information provided are true to my knowledge.
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| 1* |
Your Name (First Name, Last Name) |
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| 2* |
Date of Birth (dd-mmm-yyyy) |
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| 3* |
Email ID for registration |
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| 4* |
Contact Phone number |
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| 5* |
Contact Address |
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| 6* |
Emergency Contact person |
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| 7* |
Emergency Contact phone number |
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| 8* |
Interested in the following activities |
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Trekking |
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Scuba Diving |
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Snorkeling |
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Mountaineering |
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White water rafting |
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Para gliding / Para sailing |
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Jungle safari |
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Adventure Training |
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Skiing |
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Rock Climbing & Rapelling |
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| 9 |
Prior exposure to adventure activities |
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| 10 |
Your day choice for Outings |
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Week End |
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Week Day |
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Any Day |
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| 11* |
Your blood group |
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| 12 |
Any medical conditions? (Allergies, medical ailments that you want us to be aware of) |
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Contact us: +91 9886162404
Email: info@tagindia.net |
© TAG INDIA. All rights reserved |
