BMC Event Registration Form

  ** Important points to be noted before registering**

Please fill in all fields marked with a *

Fill out separate form for additional participants

Event Name

Trek to Mullayanagiri - Bababuddangiri Peaks & Visit Kalahatti Falls- [25th-26th-June- 2010] Two days trek at Brahmagiri with Irpu falls visit - [5th-6th Nov 2011] Photography Workshop - [12th-13th Nov 2011] Night Trek and Cave Exploring at Antargange - [25th June, 2010] One day trek to Revanasiddheshwara Betta - [26th June, 2010] Visit to Kalahatti Fall & Trek to Kalahatti peak [3rd-4th July,2010] Trek to Malana [2nd-7th July, 2010]

Name

*

Email

*

Phone

*

Payment Type

Online Transfer Credit Card on Phone Cash Paid Deposited Cash/Cheque in Bank Credit Card/Debit Card

Transaction Ref Code

Pick-up point (Mention your pickup point in remark if not mentioned here)

Wind Tunnel Road - Pizza hut Domlur - New Shanthi Sagar Lifestyle - Margrath Road

Remarks