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You may copy this form, fill it, enclose your payment and send it to
Postal Address:- CEC, Hans Bhawan Wing II, Bahadurshah Zafar Marg New Delhi-110002
Application Form for Participation
in CEC Programms
To,
The Secretary,
Climbers and Explorers Club [Regd]
Room no. 157,Gate no. 28-29, Jawahar Lal Nehru Stadium
New Delhi-110003 India
Phone: +91 11 4365930 Email- [email protected]
Website- http://cecclub.nav.to

Sir, I We would like to participate in
programme starting from To . My CEC membership number is

Name in Block Letters: Father's name:
Sex: Age:
Your postal address, Phone numbers and Email:
Experience in Climbing/Trekking and other adventure activities( if necessory attach sheets):
Next of Kin (Relationship, Name and Address):

I agree to adhere strictly to the discipline of the programme and abide by the directions of the organisers at all times during the programme.

In case of any accident, illness or injury, I will not hold the Climbers and Explorer's Club or its members responsible in any way. I declare that i do not have any infectious disease and i ma keeping good health.

I am sending the participation fee of Rs........... by M.O/ Cash/Bank Draft no:.............. Dated ............. in favour of Climbers and Explorer's Club payable at New Delhi. I have the following equipment to be used for this Programme.




Your Signature with Date

Parents/Guardian's Consent:
[To be filled in by those under 18 years of age]

It is certified that my son/doughter/ward/Mr.Ms ............. is joining .............................. programme with my consent. In case of any accident, illness or injury, I will not hold the Climbers and Explorer's Club or its members responsible in any way. It is also certified that he/ she is physically fit to undergo the rigours of the programme.


Signature of Parent/Guarian with relationship with the applicant
Name ...................... Date.................