+91 8075492364
transplantgameskerala@gmail.com
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About the Games
Venue
Regional Sports Centre, Kadavanthra
Jawaharlal Nehru International Stadium, Kochi
Lulu Mall, Edappally
Registration
Registration Guidelines
Recipient Registration
Donor or Donor Family Registration
FAQ
Supporter Registration
Events
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Video Gallery
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Recipient Registration Form
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Recipient Registration Form
Personal Information:
Full Name
*
Date of Birth
*
Gender
*
Select Gender
Male
Female
Other
Email
*
Mobile
*
Address Line
*
State
*
Select State
Andaman and Nicobar
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli and Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Ladakh
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
District
*
Location / Village / Town / City
*
Pincode
*
Medical Information:
Type of organ transplant received
*
Date of organ transplant
*
Medical team or Physician Contact Name
*
Medical team or Physician Contact Phone Number
*
Current health status and any relevant medical conditions
*
Any special medical needs required
Emergency Contact Information:
Emergency Contact Name
*
Relationship
*
Select
Parent
Sibling
Spouse
Friend
Emergency Contact Phone Number
*
Sports and Events Selection:
Sports/Events
*
5 kms Race Walk
200 Mtrs Race
Swimming
Table Tennis
Basketball Shootout
Carroms
Chess
Dart
Badminton
Bowling
Medical Clearance:
Medical Certificate from a health Care Provider or transplant medical team
Doctor Certificate (File Type- PDF/DOC , File size - Max 2mb)
Download Sample Certificate
Download
Photographs and Media Release:
Consent to use participant's photographs or media for promotional purposes
T-shirt Size:
Size
*
Select Size
XS
S
M
L
XL
XXL
Additional Comments or Requests:
Any additional information, special requests, or comments the participant wants to provide
Partners
Urology Association Of Kerala
Nephrology Association Of Kerala
Indian Society Of Gastroenterology
Cardiological Society Of India – Kerala Chapter
Society for Heart Failure and Transplantation
Kerala Liver Transplantation Society
Corporation of Kochi
K-SOTTO
Kochi Metro
Regional Sports Centre
GCDA
Lulu Mall
Kerala State Youth Welfare Board
LIFOK
