NIRALA ESTATE

GH-04, TECH ZONE – IV GREATER NOIDA (WEST) UTTAR PRADESH

REGISTRATION FORM FOR USE OF SWIMMING POOL

FOR RESIDENTS ONLY

(Please fill in BLOCK LETTERS only)

Date:

Name :
Tower Flat No. Mobile No.

Details of person to be registered:

Name Sex(M/F) Relation Age

1.

2.

3.

4.

DECLARATION:-
DECLARATION
It is to certify that NIRALA INFRATECH PRIVATE LIMITED. The company maintaining Nirala Estate, will not be
It is to certify that NIRALA INFRATECH PRIVATE LIMITED. Thecompany maintaining NiralaEstate, will not
held responsible in the event of death/ injury sustained by me or by my family members while availing
be held responsible in the event of death/ injury sustained by me or by my family members
Swimming Pool facility. No damage or compensation what so ever will be demanded by anyone whomsoever
fromwhile
Niralaavailing
Estate /Swimming Pool facility.
Nirala Infratech Nofordamage
Pvt. Ltd. or compensation
any mishap during the usewhat so ever will
of Swimming be demanded by
Pool.
anyone whomsoever
I hereby undertake:- from Nirala Estate for any mishap during the use of Swimming Pool.
(a) I That
herebymyundertake:-
family members whose names are listed above are not suffering from any contagious skin disease.
(a) That my family members whose names are listed above are not suffering from any contagious skin
(b) That in case any of the members whose name are listed above, develops any such illness in future, I shall
disease.
ensure that they use the swimming pool only after appropriate medical treatment and clearance from a
(b) That in case any of the members whose name are listed above, develops any such illness in future, I
suitable medical practitioner to ensure the best interest of the other members using the swimming pool
shall ensure that they use the swimming pool only after appropriate medical treatment and
facilities.
clearance from a suitable medical practitioner to ensure the best interest of the other members
using the swimming pool facilities.
It is also certified that the details given above are true to the best of my knowledge and belief. I and my family
shall abide by the rules and regulations of the swimming pool as may be prescribed from time to time.
It is It is alsocertified
further certifiedthat
thatI the
havedetails given
read and above arethe
understood truerules
to the best of my
pertaining knowledge
to the and belief.pool
use of swimming I and my in –
given
family shall abide the rules and regulations of the swimming pool as
“ House Rule book” and displayed on board of Nirala Estate placed near the Swimming Pool.may be prescribed from time to
time.
It is further certified that I have read and understood the rules pertaining to the use of swimming pool
given in – “ House Rule book” and displayed on board of Nirala Estate placed near the Swimming
Signature Pool.
of the Resident.

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 Obtain two photographs of the all persons applied for registration. Please issue the pass and mention
Flat Nono. ______________________________________________________________
pass Tower Pass Holder Name Obtain
two photographs of the all persons applied for registration. Please issue the pass and
mention pass no.
Estate Manager Issued dated Valid till dated

SAFETY Estate Manager

1. Do not attempt “Head First” dive.

2. Abstain from entering the Swimming Pool if you have aliments like Asthma, Epilepsy,
Cardiac complications etc.
3. Beginners should inform life guard before entering in to the pool.
4. Shout for help immediately, if experience the cramp or any physical disorder while swimming.
5. Do not enter the pool after consuming alcohol or any other intoxicating material.
6. Smoking is prohibited in swimming pool area.
7. Please enter your card number in the register provided at the pool desk before entering in to the
pool.
8. If any I-card lost by resident it will re-issue on chargeable basis amount Rs.100/-.

Timings (Tuesday closed)

Morning session : 06:00 AM – 10:00AM
Evening session : 06:00 PM – 10:00PM

Note: NO MEMBER WILL BE ENTERTAINED IN THE SWIMMING POOL WITHOUT SWIMMING I – CARD

INDEMNITYBOND
INDEMNITY BOND
I I ____________________resident of Flat no.& Tower ______
resident ofinFlat
Project
no.&Nirala
Tower Estate, GH-04, TECH ZONE
in Project
– IV GREATER NOIDA (WEST) UTTAR PRADESH do hereby confirm that I fully
Nirala Estate, GH-04, TECH ZONE – IV GREATER NOIDA (WEST) UTTAR PRADESH do hereby confirm that I understand and agree
unconditionally
fully understand that and management and employees
agree unconditionally of Nirala Estate/
that management andNiralaInfratech
employees ofPrivate
Nirala Limited
Estate/ Nirala
(company maintaining Nirala Estate) will not be responsible or liable
Infratech Private Limited (company maintaining Nirala Estate) will not be responsible orfor any injury, disability, accident
liable orfor
death, of self, my spouse, my dependent or my guest(s) while using the swimming
any injury, disability, accident or death, of self, my spouse, my dependent or my guest(s) while using pool, or within the the
area of the
swimming swimming
pool, or withinpool
thecomplex,
area of thewhich includespool
swimming thecomplex,
main swimming pool, children
which includes swimming
the main swimming poolpool,
and all swimming
children the attached poolfacilities
and all of
thethe pool. facilities of the pool.
attached
I, my spouse, my dependents are usingguests
I, my spouse, my dependents and my swimming are using
pool swimming pool
at our/ their ownat our/ theirperil
risk and ownand
riskthis
andindemnity
peril
and this indemnity bond which has been signed by me out of my own will and
bond which has been signed by me out of my own will and discretion covers the period of one year discretion covers the from
theperiod of one
date of yearof
opening from
thethe date of pool
swimming opening of theEstate,GH-04,
of Nirala swimming pool of Nirala
TECH ZONE EstateGH-04,
– IV ,GREATERTECHNOIDA ZONE –
(WEST)
IV GREATER NOIDA (WEST) UTTAR PRADESH and shall be renewed
UTTAR PRADESH and shall be renewed every year thereafter by me if I decided to do so. every year thereafter by me if I
decided to do so.
Signed on dated
Signed this _______________ day of _____________________________2018 at NOIDA
Signature
Signature___________________
Tower & Flat No Mob E-Mail Id
Tower & Flat No _____________________Mob __________________ E-Mail Id
___________________________

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