To,

The Director of Phy. Educ. & Sports,

University Sports Pavillion,
Marine Lines, Mumbai – 400 020.

With reference to your circular No./ 32 of 2023-24 dated 17/11/2023, I write inform you that,
I will be available to represent the University of Mumbai in the 4 th edition of Khel India University
Games is scheduled to be held from 18th February 2024 to 29th February 2024 at North East State of
India i.e., Assam, Arunachal Pradesh, Meghalaya, Mizoram, Nagaland, Sikkim & Tripura. I hereby
solemnly declare that I am not employed on full time basis.
Yours faithfully

Signature

Full Name : MANE AAKASH JAYWANT SHUBHANGI

(IN CAPITAL) (Surname) (First Name) (Father’s Name) (Mother’s Name)
Residentiol Address : ……………..
Mobile /Phone Mo. Resi: or Guardian’s Office:
Submitted through the Principal, Rajiv Gandhi NightCollege of Arts & Commerce college
Shr/Kum. Mane Aakash ……….. is a bonafide student & not employed on full time basis.
His particulars of eligibility are as under:

Mention Years of
Month Previous Name of
Date of Year of First Admission
& year participation in Year of
Duration
of Inter University Degree
Date of Present of
Passing Obtained
Birth Class Present
HSC to the to the (for Post
Course to the Gradu Post
(XII Present Present Graduate
Std) University ation Graduation Only)
Class Course

Feb
17/09/2005 F.Y.B.A. 3 Years 2023 2023 2023 Nill Nill Nill
2023

Place: Mumbai-400083 Principal

Date: 12th February 2024
College seal
 University of Mumbai
(Sport Department)
Undertaking Form

I permit my Son Mane Aakash….. to participate in the 4 th edition of Khel India University Games
is scheduled to be held from 18 th February 2024 to 29th February 2024 at North East State of India i.e.,
Assam, Arunachal Pradesh, Meghalaya, Mizoram, Nagaland, Sikkim & Tripura at our own risk. I have
also no objection in sending my son with University team even if the rail journey reservation is not
available. He is medically fit to participate in such a strenuous combative sport. I will not hold the
University or its staff wholly or partially responsible for any accident or injury or mishap that may
occur during the above-mentioned tournament & shall not claim for any damage injuries accidents atc.
Occurred while participating in the competition.

Place: Mumbai

Date : 12/02/2024
Signature of Parent / Gurdian)