WILLINGNESS / RISK CERTIFICATE
This is certify that Reg. No _________________ Rank________________
Name:______________________________S/O________________________________________
Name of the Institution: _______________________________________________________
Unit : ___________________________________ willing to attend _______________________
at _____________________________ from _________________________. to at my own risk.
Station:
Signature of the cadet
Date : 2025
PARENT CONSENT CERTIFICATE
This is to certify my consent and willing to send my Son//Daughter__________________
for ____________________at ______________________from ________________________ at
my own risk.
Station:
Signature of the Parent/Guardian
Date : 2025 Name & Address
MEDICAL CERTIFICATE
Certified that I have examined No _________________________ Name of the
College/School _______________________________________________________________
UNIT: ____________________________________ In accordance with the standard laid down
in NCC Act and Rules and found her fit to undergo________________at____________________
from ________________________ I also certify that the above Officer/Cadet has inoculated/
vaccinate, against small pox, Cholera, Typhoid Fever and Tituanus. The Cadet/Officer is not
suffering from any infectious disease.
Station :
Dated : 2025 Signature of Medical Officer
With seal
ATTFESTED BY THE HEAD OF THE INSTITUTION
Station : Kurnool
Signature of the Principal
Date : Headmaster with seal
COUNTEFRSIGNED BY THE CO UNIT
Station : Kurnool
Date : 2025
FORM OF INDEMNITY BOND
In consideration of my being nominated at my request as a participant in any
camp/Course/advance training activities and traveling. I undertake and agree that neither I nor
my executor nor administrator will make any claim against the Govt. of India or against any
officer ,JCO, OR Civilian MT Driver or against any person in the ser1vice of the Govt. of India in
respect of any loss or injury to the property of person (including injury resulting death) which I
may suffer while or in consequence of my participation and I understand that no compensation of
my participation and I under-stand that no compensation will be paid by the Govt. of India or an
Officer, JCO, OR Civilian MT Driver in respect of any such loss or injury and I agree so as to
bind myself executors and administrators to indemnity the Govt. of India, any Officer, JCO, OR
and Civilian MT Driver and any person in the service of Govt. of India against any claim which
may be any third party against them or against them existing out of any act of default on my part
during or in connection of said training/camp/any journey.
Signed in presence of (Signature of the Cadet)
NAME IN BLOCK LETTERS
Address
WITNESS:
1. Signature(with date)
_____________________
Name in block letters
{ } Countersignature of Father or
Guardian Address With date &
Name in block letters
Address :
2. Signature(with date)
_____________________
Name in block letters
{ }
Address
DROWING / ACCIDENT CERTIFICATE
1. I know that there is deep water near the camp site-enroute and the area of the water is OUT
OF BOUNDS . If go there I shall do so at my own risk.
2. I have been explained the orders regarding the precautions to be taken against drowning
accidents and have understood them I have been told not to go near the water in the vincity and if
I go to any one of these out of bound areas . I shall do so at my Own risk.
Signature of the Cadet
COUNTER SIGNATURE OF OC UNIT
Station :
Date : 2025
