• The Club
  • Facilities
  • Membership
  • Activities
  • Applications
  • The Affiliated Clubs
  • Room/Area Booking & Subscription Payment
Intent For Life Time Membership
Fields marked with (*) are compulsory  
Personal Information
(first name)

(middle name)
Date of Birth *
(dd/mm/yyyy) ex: "16/01/2003"
Qualification * Occupation

Date of Marriage



Name of Spouse

Date of Birth [Spouse]

Name & Date of Birth of Children
   Name Gender Date of birth
Contact Details
Office Address Home Address *
Office Add. Pincode Home Add. Pincode
Office No. Fax No.
Mobile No. Residence No. *
Email-id *
    Name Membership number    Relation
Name & Address of Nominee/s:(Spouse, son & Daughter)
    Name Address    Relation
Other Details
Blood Group Pan no.
Sports in which you are interested
 I agree all the "Rules and Regulations" of goregaon sports club and i will abide by them.
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