BHARAT SCOUTS AND GUIDES
BANGALORE NORTH DISTRICT
KARNATAKA DARSHANA
TOUR TO HERITAGE CENTRES OF KARNATAKA
APPLICATION FORM
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01. NAME OF THE SCOUT / GUIDE
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01. NAME OF THE SCOUT / GUIDE
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02. FATHERS NAME
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03. MOTHERS NAME
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04. NAME OF THE SCOUT MASTER / GUIDE CAPTAIN
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05. DATE OF BIRTH BLOD
GROUP :
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06 RANK IN SCOUTING / GUIDING
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07. SCHOOL SCHOOL
PHONE NO
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08. RESIDENCE
RESIDENCE PH NO:
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RISK CERTIFICATE
It
is certified that my son / Daughter / Ward ……………………………………………….
Is
joining the above mentioned programme with my consent and Bharat Scouts and
Guides ,
Bangalore North District or its Office Bearers shall not be
responsible for any Illness, Injury
or
Accident during the event or Journey periods for the purpose . It is further
certified that
He / She is physically fit to attend the Karnataka Darshana
Tour, organized by the Bangalore
North District from to
Signature of
Father / Guardian Signature of Mother / Guardian
Signature of the Head of the Institution Signature of District
Organiser
Date: District Secretary
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