RSFI Annual Skater Registration Application No.Blood GroupA+A-B+B-AB+AB-O+O-Full Name *REPRESENTING STATEANDHRAPRADESHFather Name *DISTRICTSGUNTURANANTAPURKURNOOLCHITOORKADAPAVISHAKAPATNAMVIJAYAVADADate of Birth:DaySelect day12345678910111213141516171819202122232425262728293031MonthSelect month123456789101112YearSelect Year212521242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925Club / Coach Name (Just for Reference): Type here(Maximum 4 Lines)AgeAge GroupGenderMALEFEMALEMOBILE NO:EmailStreet AddressCityStateZIP / Postal CodeDISCIPLINESPEED-QUADSPEED-INLINEINLINE-FREESTYLEINLINE-ALPINEINLINE-DOWNHILLALPINE-DOWNHILLROLLER-FREESTYLESKATE-BOARDINGROLLER-SCOOTERSPEED-QUADRINK-1RINK-2RINK-3ROAD-1ROAD-2ROAD-3SPEED-INLINERINK-4RINK-5RINK-6ROAD-4ROAD-5RAOD-6SELECT IMAGEChoose FileNo file chosenDelete uploaded fileNote-I: Skaters have to participate in one discipline only i.e. in Speed-Quad or Speed-Inline in their own age group, Upper Age Group jumping is not permitted. Note-II: ELIGIBILITY: Skaters studying/domicile now in Andhra Pradesh and have done RSFI online Annual Skaters Registered for the year 2025-26 only will be allowed. I / My ward wish to participate in the above championships for the above mentioned (√) events.I / I on behalf of my ward, hereby confirm and declare that any injury / Damages / Loss caused during the above Championship to myself / my ward, APRSA/RSFI/DRSA and their officials/Organizers will not be responsible or liable for the same. I / My ward is aware that(a) Anti Doping Rules of National Anti Doping Agency (NADA) is applicable to all participants. The players can be medically examined by the concerned agencies or any other agency advised by the government/APRSA/RSFI (India Skate)/CARS (World Skate-Asia)/FIRS (World Skate) at any point of time. The State Association/Federation may ask for necessary medical certificate/s in this regard from any player at any point of time. Expenses if any in this regard are to be borne by the concerned skater/s. (b) I / My ward is aware that I / My ward have to take Accident/Medical/Life Insurance Policy before participating in the Tournament.I / My ward is aware that as per rules, only the RSFI registered skaters are allowed to participate in Internationals, Asians and RSFI approved National-All India-Memorial-Invitational-Open Tournaments and the State/U.T Units approved State—District & other local championship, hence participation in any competition & / or championship/Tournament (wearing Inline-Roller Skates/Skateboard) which does not have the approval of RSFI/APRSA/DRSA will lead to disciplinary action/disqualification. I / My Ward hereby confirm and declare that I/ My ward have/has not taken part in any championship/Tournament held during 2023-24 & 2025-26 which did not have the approval of RSFI/APRSA/DRSA. I/ my ward further agree that the above confirmation and declaration if found wrong, I am/ my ward is ready to accept any decision/action as deemed fit taken by APRSA. I / I on behalf of my ward, also confirm and declare that I / My ward am / is aware of all the latest Rules & Regulations of APRSA/latest RSFI 11RR & the Tournament Circular and I/my ward have/has read & understood the Rules & Regulations of the sport of Roller Skating and agree to abide by the same.I AGREE & SUBMITPlease do not fill in this field.