I hereby declare that the particulars given on this form are correct and true to the best of my knowledge and believe. I fully realized that any false information and willful and suppression of the facts will render me liable to disqualification from the course. I agree to attend the course and to strictly abide by all the standing orders, rules and regulations of the institute.

I hereby undertake to indemnify the Maritime Training Institute,  it’s servants and agent, against any claim arising any accident, injury or death whatsoever occurring to or sustained during the course at the MARITIME TRAINING INSTITUTE or any other place of training and I undergo this course on my own accord.