ENTRY 21ST DELHI STATE INTER-SCHOOL SHOOTING COMPETITION 2017 Attach

Two Photos
FORM FILL THIS FORM IN MS-WORD AND THEN PRINT IT
(Paste one,
LAST DATE : 9 July 2017 staple one)
To,
The Secretary, Delhi State Rifle Association.

Sir,

I wish to participate and represent my school in the above mentioned competition, I am aware of the rules and regulation of
Shooting sport and I shall abide them in sportsman spirit.

1. Name (In Block Letters) Click here to enter text.

2. Fathers / Mothers Name Click here to enter text.

Click here to enter text.

3. Name & Address of School
Click here to enter text.

4. Date of Birth (Enclose proof) Click here to enter text.

Click here to enter text.

5. Residential Address
Click here to enter text.

6. Contact Phone No.: Click here to enter text.

7. E-Mail Click here to enter text.

8. DSRA Membership No. Click here to enter text.

9. Match No Click here to enter text.

10. Entry Fee Enclosed Click here to enter text.

I hereby certify that neither I nor anyone on my behalf will make a claim of any nature against DSRA in event of any injury or
accident sustained by me or through me and that I will be responsible for my conduct during the competition and I further
undertake that I shall represent Delhi State in all shooting competitions for the next two years. I have not been disqualified by
NRAI to participate in this competition and I shall abide by all the rules of NRAI Rule book and I also understand that I shall be
debarred from further competitions, if any information given above is found to be false or incorrect.

________________________________________ ______________________________
(Signature of School Authority with School Stamp) (Signature of Competitor)

Encl:
1. Attested Copy of Municipal Birth Certificate or NRAI Shooter ID Card.
2. Two Passport Size Photographs with your name written on the reverse side.