34 Karnataka BN NCC Ballari: Name of The Camp & Date

34 KARNATAKA BN NCC BALLARI
CAMP DOCUMENT
Name of the Camp & Date: IDSSC-1/CATC CAMP & 22/04/2024 to 01/05/2024
Regimental No, Rank and :
Name of the Cadet :
Mobile No : :
Father’s Name :
Mobile No :
Contact No of Principal : +91 9448755268

Contact No of ANO : +91 8095027146
Name of institution : Ballari Institute of Technology & Management,

Type of institution : Ballari-583104
State Govt / Govt Aided / Self financing
Unit , Location, : 34 Karnataka Battalion NCC, Ballari

Group : NCC Group HQ, Ballari
Name of the Camp, Location : IDSSC-1/CATC Camp, Toranagallu, Ballari.

& date 22/04/2024 to 01/05/2024
1. Volunteer and Risk Certificate. It is hereby certified that I am a volunteer and am willing
to attend the camp / activity at the location and for the duration given above, to be conducted by
the NCC Unit mentioned above, at my own risk.
Signature of cadet_________________
2. Drowning/Accident Certificate. I have been instructed and am aware that all water
bodies including ponds and wells in the camp area or in places near the camp site or enroute to
the camp site are OUT OF BOUNDS and I am forbidden to go near any such water bodies. If I do
so, it shall be at my sole risk and shall be liable for disciplinary action as the Camp Commandant
deems appropriate. I have been explained regarding the precautions to be taken against
drowning accidents and have understood them.
Signature of cadet_________________
3. Indemnity Bond. To, The President of India : In consideration of my being nominated
either by the NCC authorities or at my own request as a participant in any NCC camp / activity
(which may include Republic Day Camp or any other camp / activity in India or abroad), Course,
Adventure Training (including Army, Navy and Air Wing activities, as the case may be) and while
travelling (in domestic/international surface, air and water transport) and attending Youth
Exchange Programmes abroad, I undertake and agree that neither I, nor my heirs, executors,
administrators or other legal representatives will make any claim against the Government or
against NCC authorities including Officers, JCOs, NCOs or their equivalents from Navy and Air
Force, Civilians, MT drivers or against any other such person in the service of the Government, in
respect of any loss or injury to property or person, including injury resulting in death, due to any
reason whatsoever which I may suffer, while or in consequence of my participation in the above
activities and I understand that no compensation will be paid by the Government or NCC
authorities including Officers, JCOs, NCOs or their equivalents from Navy and Air Force or
Civilians or MT drivers in respect of any such loss or injury or death and I agree to bind myself,
my heirs, executors, administrators and other legal representatives to indemnify the Government
or NCC authorities including Officers,
-2-
JCOs/NCOs or their equivalents from Navy and Air Force, Civilians or MT drivers or any person in
the service of Government against any claim which may be from any third party against them
arising out of any act or default on my part during or in connection with the said camps, courses,
adventure training, travelling and while on Youth Exchange Programme or any other such NCC
activities as may be organized from time to time within or outside the Union of India.
Dated this ______ (day) of __________ (month) 20_____at ___________________(place).
Sign of Cadet ______________

Sign of Witness 1_____________________________________
Address ____________________________________________
Sign of Witness 2 _____________________________________
Address_____________________________________________
4. Parent’s/ Guardian’s Consent. I, _____________________________________(name),

resident of ________________________________________________________________ (address),
being the father / mother / guardian of the cadet whose particulars are given overleaf, do hereby
give my consent to my son / daughter / ward to participate in NCC camps / activities (including
adventure training, adventure activities and Youth Exchange Programmes) that may be conducted
in India or abroad and for his / her travel by domestic or international surface, air or water
transport, in the event of his / her being detailed for such camp / activity at his / her own request
or on being so nominated by the NCC authorities. I also agree to all terms and conditions of the
NCC organization that relate to participation of cadets in NCC camps and activities.
Sign of Parent ________________________________ Mobile No: _____________________________
5. Attestation by Principal / Head Master of The Institution. Certified that the above
named Cadet is a bonafide student of my College/School studying in class _________________ . He
/ She has been found fit to attend the NCC camp / activity and can be spared for the duration of
such camp / activity. Also certified that this institution is State Govt run /Govt Aided / Defense /
Self financed. (PLEASE TICK THE CORRECT OPTION.)
Sign and Stamp of ANO______________________ Sign and Stamp of Principal ____________________
6. Medical Fitness Certificate. Certified that I have examined the cadet whose details have
been given overleaf, in accordance with the standards laid down in NCC Rules and I have found
him / her FIT to undergo the NCC Camp / activity. I also certify that the Cadet has been
inoculated properly and is free from infectious diseases including H1 N1.
Date: Signature and stamp of Medical Officer
7. Certificate from the OC NCC Unit. Certified that I have explained the orders regarding
precautions to be taken against drowning / accidents and explained to the cadets not to go to
locations / areas that have been designated by the Camp Commandant as ‘OUT OF BOUNDS’. The
cadet has signed in my presence.
Signature of Cadet ________________ Sign and stamp of the OC Unit _________________
Date :
Place:

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34 KARNATAKA BN NCC BALLARI

Contact No of Principal : +91 9448755268

Name of institution : Ballari Institute of Technology & Management,

Unit , Location, : 34 Karnataka Battalion NCC, Ballari

Name of the Camp, Location : IDSSC-1/CATC Camp, Toranagallu, Ballari.

Sign of Cadet ______________

4. Parent’s/ Guardian’s Consent. I, _____________________________________(name),

Sign and Stamp of ANO__ Sign and Stamp of Principal

Date: Signature and stamp of Medical Officer

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