Form - II
DEPARTMENT OF YOUTH AND SPORTS
GAMES AND SPORTS DIVISION
CONSENT FORM FOR PARTICIPATION
(For Teachers/Coaches/SSI)
A. Consent of an Individual/Nominee:
I, whose details as given below hereby agree to be selected as player/delegate of the contingent
to participate in the ………………………………………………………..……….. to be held at
(city & country)……………...... .................................. from ………….………to …………….
Name : ……………………………………….
DOB : …………………………………….…
Gender: ……………………………………….
School : ……………………………………….
Dzongkhag: …………………………………..
Signature of the Nominee:
Date:
I also hereby provide the consent of my school and Dzongkhag for my participation in the
program:
B. Consent of School/institute:
As the Principal/Head of the ………………………………………………………………………,
I have no objection in allowing Mr/Ms………………….…………………………………… of
this school/institute to participate in the .…………………………………………………….……
whereby he/she may be absent from the school from …………………….. to ……………………
Name of the Principal / Head: …………………………………………..
Signature and seal of the school/institute:
Date:
1|G S D , D Y S . F o r m
– II
(Consent
form
for adults)
C. Consent of Dzongkhag:
As agreed by the individual and the school concerned, the Dzongkhag Education Office have no
objection to releasing Mr/Ms………………………………………………………………… for
the above-mentioned ex-country program:
Name of the DEO:
Signature and seal of the office:
Date:
…………………………………………………………
D. Endorsement by the National Sports Organization:
As the responsible National Sports Organization and coordinating agency for the ex-country
participation, we are fully aware of the program and also have sought consents from the
respective individual and organization.
Name of the Endorsing Officer: ………………………………………………….
Signature and seal of the office:
Date:
2|G S D , D Y S . F o r m
– II
(Consent
form
for adults)