HOME PHOTO GALLERY TRAVELOGUE EVENTS ARTICLES CONTACT US

Membership Application Form

If you are interested in joining the 'Bangalore Mountaineering Club', please fill in and submit the below application form. Upon receiving your details one of our representative will contact you via phone or email. If you have any queries please feel free to contact me.

 

Field names given in bold letters are mandatory

First and Last Name    
Address  
Occupation
dob (dd/mm/yyyy)  
E-mail (Recommended Yahoo id for Yahoo Group)  
Phone Number (M)  
Phone Number (R)
Phone Number (O)
Blood Group  
Please give one nearest reference with Name & Phone number.
(Should be your kin, room-mate or colleague)
Are you a member of other any other adventure club?
Which one(s)
Where did you hear about 'Bangalore Mountaineering Club'? (Write Name of person, search engine, website or media)
Describe your experience about trekking,
mountaineering or other adventure sports.
In which activities you are more interested?
Day Outings Cycling
Weekend Outing Water Sports
Long Camps Wildlife
Trekking Mountaineering
Rock Climbing Paragliding
Other (Specify)
Any Special Comments:
Participant statement:
I am applying to join the 'Bangalore Mountaineering Club'. I recognise that climbing, mountaineering, trekking and jungle safaris are activities with danger of personal injury or death. In participating in these activities I am aware and accept these risks, and am responsible for my own actions and involvement.

Being an outdoor and adventure activities conducted at various places having no much of facilities, I understand that all the programs will be conducted in non-luxury environment. I have read the club constitution and agree to be bound by it and any subsequent amendments 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.

I understand that after becoming club member I would be a part of club's Yahoo Group [mountaineering]. Email id submitted by me will be added to Yahoo Group to stay in touch with other group members.

Please contact me, If you are facing any problem while submitting this form.
Register with us to get added to mountaineering@yahoogroups.com

HOME