From 1 November 2021, Registration fee of Rs 300 per skater for each year has to be paid. (This fees will be valid till 31 March 2022) Name of the Skater (capital letters) Name of Father/Mother Sex Male Female Date of Birth Blood Group Mobile No Email ID Address (current) Address (permanent - as per Aadhar Card) Residence City Residence State Choose State Andaman and Nicobar Islands Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli / Daman and Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Ladakh Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Puducherry Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal Pincode Upload Your Recent Photo(Please upload your recent photo in jpg format, with in 1 MB size and candidate name mention on file name) Upload Photo Upload Aadhaar Card(Please upload your aadhaar card in jpg or pdf, with in 5 MB size and candidate name mention on file name) Upload Upload Passport(Please upload your passport in jpg or pdf, with in 5 MB size and candidate name mention on file name) Upload Upload Deposit slip(Please upload your deposit slip in jpg or pdf, with in 5 MB size and candidate name mention on file name) Upload Discipline Speed Skating Figure Skating Age Category <= 10 yrs 11-13 yrs 13-15 yrs 15-17 yrs 17-19 yrs > 19 yrs Past Achievements in Ice Skating(please list out Competition Names and your standings.) Representing State Choose State Andaman and Nicobar Islands Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhattisgarh Dadra and Nagar Haveli / Daman and Diu Delhi Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Ladakh Lakshadweep Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Odisha Puducherry Punjab Rajasthan Sikkim Tamil Nadu Telangana Tripura Uttar Pradesh Uttarakhand West Bengal Declaration I am participating in the event as per own will. If I sustain any injury during the event, Ice Skating Association of India (ISAI) or any of the officials will not be hold responsible for the injury or loss of any kind. I hereby declare that:-I have attached the proof of identity, Address and date of birth as per ISAI guidelines and I will produce necessary original documents whenever asked by ISAI/State Association.I accept to receive newsletters/ any communications from ISAI and any service providers associated with ISAI.I hereby declare that all the information furnished by me is true to the best of my knowledge and belief. I HEREBY UNDERTAKE THAT I WILL ATTEND THE TRAINING CAMP AND CHAMPIONSHIPS CONDUCTED BY ISAI REGULARLY. Date Place (Signature of Skater) (Signature of Parent in case of minor) Contact Address 7/19, Ansari Road, Daryaganj, New Delhi - 110002 Contact iceskatingindia@gmail.com Contact Phone Tel. : 011-2325 7985 Fax : 011-2325 2572
