Membership Drive for Para Athletes

Membership Drive for Para Athletes - KSAPH

Membership Drive for Para Athletes

Membership Drive for Karnataka State Para Athletes has started, Para Athletes are requested to fill their details online using the link given and enroll their names and upload all necessary details without fail.

Athletes Database Management Systems will be useful for Demographic data, Sports Administrative information to determine with confidence the outcomes, quality, effectiveness, appropriateness & Statistical purposes.

Read Instructions Carefully:
*Please Fill all Necessary Details & Upload Mandatory disclosures,
Keep all necessary information & files scanned ready before you upload data online,
Avoid double entries & Confusion, before you press final sumbit button make sure you have entered correct information.

For New Athlete Registration online Form
https://ksaph.org/para-athlete-licence-2019-register

For View Athlete Mandatory Database Information
https://ksaph.org/para-athlete-licence-2019-view

For Athlete Database Identity Card
https://ksaph.org/athlete-id-card

 

Read Instructions Carefully:
*Please Fill all Necessary Details & Upload Mandatory disclosures,
Keep all necessary information & files scanned ready before you upload data online,
Avoid double entries & Confusion, before you press final sumbit button make sure you have entered correct information.


Karnataka Sports Association for the Physically Handicapped

KSAPH.Org

Sri Kanteerava Stadium, Bangalore, Karnataka State.

Questionnaire - Online Athlete Database Management Systems & Licence

Fill in this questionnaire form neatly in sentence case, along with attested copies of relevant for online submission.

 

Particulars

 

Details

Personal Details

 

 

Athlete Photograph

 

Passport Size

Athlete Name*

 

 

Gender

 

 

Date of Birth*

 

 

Father Name*

 

 

Mother Name

 

Male / Female

District

 

 

Phone No.*

 

 

Alternate Phone No.

 

 

Email*

 

Valid Email*

Phone No.*

 

 

Alternate Phone No.

 

 

Address Permanent*

 

 

Postal Pin code*

 

 

Address Communication

 

 

Postal Pin code

 

 

Marital Status

 

Single / Married

ID Card: Aadhar *

 

Aadhaar Card Number

Identity Card Upload*

 

Scanned Identity Card Aadhaar Card

Education

 

 

Disability Certificate*

 

Scanned Disability Medical Certificate

Impairment

 

Physical / Visual / Dwarf / Cerebral-palsy / Intellectual

Blood Group

 

 

Height in Centimetres

 

 

Weight in Kilograms

 

 

Wheelchair?

 

Yes / No.

Games

 

Para Athletics, Swimming, Shooting, Powerlifting, Badminton, Boccia, W.Basketball, Sitting Volleyball, Archery, W.Tennis, Taekwondo, Para Chess, etc.,

Classification

 

Para Sports:

IPC Licence Number – with Year*

 

 

Coach

 

 

Achievements

State Level:

#. Performance, Event, Place, Year

 

 

National Level:

#. Performance, Event, Place, Year

 

 

International:

#. Performance, Event, Place, Year

 

 

Achievements:

Awards, Place & Year

 

 

Undertaking

Undertaking*

 

form duly signed by Athlete & State Authority with Seal

Membership Fees

Licence Fees:

 

2000 /-

Mode of Payment

 

Online Gateway / Demand Draft / Bank Cheque / Cash with Bank / Direct

Date of Payment

 

 

Payment Receipt Reference No.

 

 

Payment Receipt*

 

Payment Receipt (.JPG File)

 

Note: Compulsorily enter the details of * asterisk marks, *Compulsorily upload the necessary documents in Good Resolution, For any Financial related / banking Inquiries,

kindly contact KSAPH office, Sri Kanteerava Stadium, Bangalore


Bank Details :

Beneficiary Name

Karnataka Sports Association for Physically Handicapped

Bank Account Number

A/c.  0868 102 00000 3155

Bank Name

IDBI Bank

Address

Shashwathi Arcade, No. 7, Attimabbe Road,
Banashankari III State, Bangalore - 560027, Karnataka

IFSC Code

IBKL0000868


Undertaking Format - Declaration by an Athlete and Endorsement by Respective State Unit

 

 

Letter of Undertaking

 

 

I _______________________________________________ declare that the information provided by me are true and correct and if any information is found otherwise, I will be solely responsible without recourse to Karnataka Sports Association for the Physically Handicapped ( KSAPH ). I shall abide by all the rules and regulations issued by International Paralympic Committee, Paralympic Committee of India or Para Sports Associations / Federations, for which I shall be solely liable for its compliance.

I declare that I have verified all the information and facts provided to me.

 

 

 

 

 

 

 

Signature of the Athlete*

 

 

Date: __________

Place: _________

Signature of Secretary / President

& Seal of

Karnataka Sports Association for the Physically Handicapped

 

Date: __________

Place: __________

 

Download link - PDF file