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DROWNING/ACCIDENT CERTIFICATE
1. No. ______________ Rank __________ Name __________________________
Attending _________________________________________knows that that there is
deep water near the camp site and that the area near to the water is out of bound. If I go
there I shall be doing it entirely at my own risk.
Date : (Signature of the Cadet)
Permission attested by NCC officer / Principal
As the father / guardian has given the permission to his son / daughter / ward to
attend the above NCC Camp. I therefore also permit him / her for the same.
Date:
_______________ __________________________
(Signature of ANO) (Signature of Head of Institution)
COUNTER SIGNATURE
Date : (Commanding Officer)
Place :
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RISK CERTIFICATE
This is to certify that I No ____________________ Rank ___________________
Name___________________ of college/School _______________________________
Volunteer to attend the NCC _______________________________________________
being held at ___________________________ wef ____________________________
to ________________________ at my own risk.
______________________
(Signature of the applicant)
Parent’s Consent Certificate
This is to certify that I have no objection to spare my son/daughter
No._______________ Rank ___________ Name _______________________
College_______________Unit_____________to attend the_________________ Camp/
Course being held
At__________________ from ___________________to _________________.
____________________
Station : (Sig of Parent/guardian)
Name and address
Dated : ____________________
____________________
___________________________
________________ (Signature of Head of Institution)
(Signature of ANO)
COUNTERSIGNED
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(Signature of Commanding Officer)
Annexure I
(Ref to Para 1 (a) of Appx C)
MEDICAL CERTIFICATE
1. (a) Certified that I have examined No ____________________ Rank ________
Name _________________________________ of College ______________________
of Unit _____________________________________ in accordance with the standard
laid in NCC Acts and Rules found her fit to undergo training of ___________________
____________________camp to be held at _______________________________ wef
____________________ to ________________________.
(b) I also certify that the above mentioned cadet has been inoculated / vaccinated.
(c) That the cadet has been protected against small pox, typhoid and cholera.
(d) Signature of cadet ____________________
(e) Signature of cadet ____________________ is attested.
Station: Signature of Medical Officer
Name in block letters
Date: Designation
PractionerLicensee No.
“COUNTERSIGNED BY THE OC UNIT”
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Annexure III
(Ref to Para 1 (c) of Appx C)
INDEMNITY BOND
In consideration of my being nominated either by NCC authorities or at my request to undergo all
types of training and also participate in any Camp/Course/Adventure Training activities/in/outside NCC and
traveling, I undertake and agree that neither I nor my executor or administrator will make any claim against
the Govt of India or against any Officer, JCO/OR, Armed Forces/Civilian MT Driver or against any injury
(including injury resulting in death) which I may suffer while or in consequence of my being in
Training/participation in any camp/course/adventure training activities in/outside NCC and traveling, and I
understand that no compensation will be paid by the Govt of India or any Officer, JCO/OR, Armed
Forces/Civilian MT Driver against any in the Govt. of India and in respect of such loss or injury (including
injury resulting death) and agree so as to bind myself, executors and administrators to indemnity the Govt. of
India any Officer, JCO/OR, Armed Forces/Civilian MT Driver and any person in the service of Govt. of India
against my claim which may be made by any third party against them or any of them arising out of any act of
default on my part during or in connection of said training/camp/course/adventure training and journey by
In presence of Witness
road/rail/sea/river and flight.
______________________
Station _________________ (Sig of the Applicant)
Date _________________ Name in block tters____________________
With address _______________________
`
_________________________
_________________________
Signature 1: Signature 2:
With date : _____________________ With date : ___________________________
Name in Block letter__________________ Name in Block letter_____________________
With address ____________________ With address ________________________
____________________ ________________________
Father (Guardian)
Name in block letters______________
Address ________________________
________________________
____________________
____________________________
(Signature of ANO) (Signature of Head of Institution)
Countersigned CO Unit
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