THE BHARAT SCOUTS AND GUIDES, NATIONAL TRAINING CENTRE

PACHMARHI { M.P. } – 461881.

Ph. No. 07578—252026 (O), 252153 (R), Fax No. 07578 – 252541

E-Mail bsgntc@sancharnet.in

Circular No- 11 / 1222-25 / 2010 Dated : 24.06.2010

All the State Secretaries,

Bharat Scouts & Guides,

Indian Union

Sub : 13^th Adventure Leaders Course.

Dear Sir/ Madam,

I am glad to inform you that the 13^th Adventure Leaders Course will be held at National Adventure Institute of Bharat Scouts and Guides, Pachmarhi, Madhya Pradesh from 14^th to 23^rd September 2010. The details about the course are as follows:

Name of the Event	:	13^th Adventure Leaders Course.
Dates	:	From 14^th to 23^rd September 2010 (Ten days).
Venue	:	National Adventure Institute of Bharat Scouts and Guides, Pachmarhi, Madhya Pradesh- 461 881.
How to reach	:	The nearest Railway Station is PIPARIYA. The distance from Pipariya to Pachmarhi is 56 Km. Buses are available from Pipariya to Pachmarhi. Number of Private jeeps are also available on nominal rate. The Adventure Institute is just 5 km from Pachmarhi Bus Stand. Local Conveyance available to reach National Adventure Institute from Pachmarhi Bus Stand. Those who are coming by private jeep can directly come up N.A.I. on request to the Jeep Driver.
Who can attend	:	· Young Leaders between 21-45 years of age, having good health, interest to start the Venture Club and work with young people to help them in their personal development. · Educationally qualified- Minimum Higher Secondary passed. · Former Rastrapati Scouts/ Guides, Rovers/ Rangers, SGV’s may apply. · Candidates should be physically fit and can bear the strain of Adventure. Each candidate should submit physical fitness certificate from the appropriate authority as well as one passport size photograph in Uniform.
Development Fee	:	Development Fee Rs. 100/- per head will be charged at the time of Registration in the Camp from Every Participants.
Special Fee	:	Rs. 30/- per head will be charged at the time of Registration.
Financial Assistance	:	National Headquarters will reimburse the Second Class Concessional Train Fare and Actual Bus fare (on shortest route where there is no Train route) on production of Photocopy of Train Tickets and Bus Tickets in Original. (No. Taxi / Auto fare is allowed).
Date of Reporting	:	14^th September 2010 before lunch in proper uniform.
Date of Departure	:	23^rd September 2010 after lunch.
Materials to be brought	:	Malaria Test report (Tested with in a week before departure). Application form, Medical Risk Certificate as per Performa attached. Two Sets of Correct and Complete Uniform as per APRO Part II and III, toilet requisites, water bottle, torch, pen, notebook, diary, mug, plate, spoon, odomos cream etc. Dress for Cultural Programmes for campfire, personal first aid kit, Tracksuit, jeans pant (Blue), T- shirt (grey), P-cap, sleeping bad, bed sheet, full sleeves shirt, mat plastic sheet, knotting rope 3 metres, comfortable sports shoe, rain coat, warm clothing’s and personal dress and other materials required for the camp.
Quota allocation	:	Each State is allotted a quota of 7 candidates (5 Scouter & 2 Guider).

The list of participants with address and qualification should reach to the Dy. Director (Adventure Programme) National Adventure Institute of Bharat Scouts and Guides, Pachmarhi on or before 30^th August 2010 positively with a copy to the undersigned. State Training Commissioner of Scouts and Guides are personally requested to take initiative to depute the participants and utilize the quota.

Thanking you and with regards,

Thanking you,

Yours Sincerely,

( M. S. Qureshi )

Dy. Director (S) Ldr. Trg.

Encl.: Application form.

Copy to :

1. All the NHQ Office Bearers.

2. The Asst. Directors.

3. Public Relation Officers.

4. The State Trg. Commissioner (S).

THE NATIONAL ADVENTURE INSTITUTE BHARAT SCOUTS & GUIDES

PACHMARHI {M.P.} – 461881.

PHONE & FAX NO. 07578 – 252350 (O)

E. Mail: bsgnai@yahoo.com

APPLICATION FORM

FOR ___________ADVENTURE LEADERS COURSE

FROM _________ TO__________

Name of the Applicant (In Capital) : ________________________________
Father’s Name: _________________________________________________
Home Address (In Capital): _______________________________________

_______________________________________________________________

Distt._______________State ___________Pin Code ____________________

Telephone/Mobile No. _________________E-mail_____________________
Date of Birth_______________________Age in years___________________
Experience in Scouting /Guiding ____________________________________
Experience in Adventure Activities ___________________________________________________
Special Hobbies or any other information : _____________________________________________
Number and date of the draft drawn on State Bank of India, Pachmarhi (M.P.) Code 1046 in favour of “The National Adventure Institute of Bharat Scouts and Guides” for an amount of Rs:_________ being the non-refundable fee D.D. No._____________ dated ____________ enclosed.

Signature of the Applicant

DECLARATION

I agree to adhere to the discipline of the movement and programme in particular and abide by the rules and regulations of the Institute during the whole event.

In case of any accident, illness or injury, I will not hold the National Adventure Institute of Bharat Scouts & Guides responsible at all.

I further declare that I have not been in contact with any infectious disease for the past one month and that I am keeping good health & physically fit to undergo the Adventure Programme.

Signature of the Applicant

For office use

Selected/Not Selected

Programme In charge

Reg. Fee Rs__________________ R.N. ________________ Date _______________

Camp Fee Rs ________________ R.N. ________________ Date _______________

Booking SL NO.______________ Camp NO.____________

Signature

THE NATIONAL ADVENTURE INSTITUTE BHARAT SCOUTS & GUIDES

PACHMARHI {M.P.} – 461881.

PHONE & FAX NO. 07578 – 252350 (O)

E. Mail: bsgnai@yahoo.com

MEDICAL CERTIFICATE

Name ________________________________________________________________________________

Address _______________________________________________________________________________

Date of Birth _________________________________________Single/Married ______________________

1. Present/Past illness of Significance _______________________________________________

2. Injuries / operations undergone and present condition ________________________________

___________________________________________________________________________

3. Any known allergy to drugs or food stuff __________________________________________

4. Blood Group No. ____________________________________________________________

Is the Applicant Suffering from

(i) Any Infectious disease Yes/No

(ii) Any Skin disease Yes/No

(iii) Mental disease Yes/No

(iv) Heart Trouble Yes/No

(v) Asthmatic Yes/No

(vi) Any Other Disease/defect Yes/No

I, on this date ________________ have examined Mr./Miss ________________and found

Him/her medically fit/unfit to undergo an Adventure Programme.

Medical Officer

Registration Number & Designation

Date ___________ Office Seal

RISK CERTIFICATE

(FOR USE OF APPLICANTS OF BELOW 18 YEARS OF AGE)

It is certified that my son/daughter / ward Mr./Miss ___________________________________is joining the above mentioned Adventure Programme with my consent and the organizer shall not be responsible for any illness, injury or accident during the event or journey periods for the purpose. It is further certified that he/she is physically fit to undergo the said rigorous programme.

Signature of Parent/Guardian

Relationship with participant ________________________

Name ___________________________________________

Address __________________________________________

_______________________________________________