Application Form

Application form for Hyderabad Climbing Championship - Winter 2012 ( Natural Bouldering Competition)
Last date to fill application form: 17-Dec-2012.

* Indicates required field

Name *

First

Last

Email *

Age *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone *

Cellphone *

Your payment option *

Credit Card NEFT to GHAC account Claiming 100% discount

NEFT instructions

Please transfer Rs. 500 per participant to the following back account.

If you are a finalists in 2011 or 2012 IMF competitions, transfer only Rs. 250 ( 50% discount).
If you are a winner/second in 2011 or 2012 IMF competitions, you do not need to transfer.
If you are a Hyderabad local participant, please transfer Rs. 375 only ( 25% discount)

Great Hyderabad Adventure Club, A/C No 038205001748 (Current Account),
ICICI Bank Ltd, Road No 12, Banjara Hills, Hyderabad.
NEFT/ISFC Code: ICIC0000382
Please mention HCC12_yourname, in comments while transferring amount.

Paying using Credit Card

Please click this link to Pay using Credit Card CLICK HERE

Payment details *

Comments/Additional Information *

Submit