1 (T) AIR SQN NCC, SECUNDERABAD
RISK CERTIFIATE
This is to certify that No: _________________ Rank:_____
Name__________________________ Unit: No. 1 (T) AIR SQN NCC, SECUNDERABAD volunteered
to attend ___________________________ From______________ to ___________.
Signature of Cadet
CERTIFICATE FROM PARENT/GUARDIAN
This is to certify that No: ___________________Rank: ____________________________
Name:___________________________Institution_____________________________________who
is my Son/Daughter/Relative is From_____________to _______________.
Sig.of Parent/Guardian
MEDICAL CERTIFICATE
Certified the I have examined No: __________________Rank: __________________
Name:____________________________________Institution:____________________________
With standard laid down in NCC Act and Rules and found him/her fit to attend the camp
from:___________________to___________________. I also certified that the above mentioned
cadet has been inoculated/Vaccinated.
Sig.of Medical Officer
CERTIFICATE FROM HEAD OF INSTITUION
This is to certify that No:____________________Rank:____________________________
Name: _______________________________________who is student of this Institution is volunteered
to attend Camp/Course from__________to_____________
Sig.of the Principal
INSURANCE CERTIFICATE
Certified that No:_____________________________Rank: ________________________
Name: __________________________________________ covered in Insurance scheme as per
records maintained by this unit.
Signature of CO Unit
Appx ‘C’
FORM OF INDEMNITY BOND
In consideration of being nominated at own request as a participant in any
Camp/Course/Adventure training activities (Like Mountaineering, Rock-Climbing, Trekking,
Hikking, Skiing, Cycling and Sailing/Expedition and travelling). Undertake and agree that
Neither I nor my executor her administrator will make any claim against the Government of
India or against any person in the service of the Government of India or against any person in
the service of the Government of India in respect of any loss or injury to the property of person
(including of my being in training/participating and under that no compensation will be paid by
the Government of India or any officer, JCO/OR, Civilian MT Driver my self executor and
administrators to indemnity to the Government of India any officers JCO/OR Civilian MT
Drivers and any other person in the Service of Government of India against any claim which
may be any third party against them of any of them arising out of any act of default on my part
during or in connection of said training and journey.
The Government has agree to bear the stamp duty on this documents.
Signed by the Applicant ______________________
Signature of the Applicant
Sri: ________________________
______________________
(Signature of the Cadet in presence of ANO) (Signature of the Applicant)
__________________
(Signature of the ANO)
Signature Name (in Block Letters) and address of two witness:-
1._________________________________________
2._________________________________________
___________________________________________________________________________
ACCIDENT/DROWNING CERTIFICATE
Name & Type of Camp: Location:
I, __________________________No.________________Rank__________________
am aware of the fact that all wells/ponds/lakes/rivers, near the camp site are placed out of
bounds during the period of camp. If I go there, I shall do so entirely at my own risk.
Place:
Date : Signature of Cadet