Name (as per certificate)

Photograph

Email

Hobby

Contact no.

Facebook ID link

Present Address

Blood group
A+B+O+AB+A-B-O-AB-

Smoking
YesNo

Passport no.

Passport copy

Profession
StudentJob holderBusinessOther, briefly explain bellow

Any illness/surgery history

Tshirt size
SMLXLXXL

I know that smoking and other drugs are strictly prohibited during all Rope4 activities. I confirm that I am sufficiently fit to join the course. Rope4 or any of its staff will not be responsible for my injury, loss of limb, sickness, heart attack, or death and Rope4 will not be liable for any compensation. I want to undertake the course as per my own will. I agree that Rope4 has the sole authority to cancel the registration. I certify that all the given information is correct