Application Form

Roxilla Executive Travel Club - Membership Form

First Name *

Middle Name

Surname *

Did you ever have any other name(s)? *

If Yes, please mention your other names

Gender *

Father’s or Husband’s Name

Email *

Phone *

Your Country of Citizenship *

If Foreigner, are you a residing in India? *

Occupation *

Category of Membership *

Annual Income *

Do you use your own transportation?

If yes, which car do you have?

Car Registration Number: Upload RC Copy *

Emergency Contact *

Current Address *

Previous Address a) *

Previous Address b) *

Have you been convicted previously by any court of law in India or abroad? *

Govt. Issued Photo ID Proof Number * AADHAAR/PAN/VOTER ID/DRIVING LICENSE/PASSPORT *

ID Proof Upload *

Address Proof * AADHAAR/VOTER ID/DRIVING LICENSE/PASSPORT*

Passport Size Photo *

Please provide your hometown: * *

Have you ever been a Member of Roxilla Executive Travel Club *

If Yes,Please Provide your Membership Number

Has your membership ever been cancelled due to default by RETCIL*

If Yes, Cancellation Details

Terms and Conditions for Roxilla Executive Travel Club (India) Limited

These terms and conditions ("Terms") outline the agreement between ROXILLA EXECUTIVE TRAVEL CLUB (INDIA) LIMITED (referred to as "the Club") and the members (referred to as "you" or "the member" or “the members”) participating in ROXILLA EXECUTIVE TRAVEL CLUB program, including male, female and trans-genders whichever may be applicable even if it is written here in only male gender or only in female gender, including singular and plural. By joining ROXILLA EXECUTIVE TRAVEL CLUB (INDIA) LIMITED, the applicants agree to abide by these Terms and Conditions before applying. Please read them carefully before submitting the APPLICATION FOR MEMBERSHIP.

1. Membership in ROXILLA EXECUTIVE TRAVEL CLUB (INDIA) LIMITED is open to individuals of 18 years age including NRIs. Foreigners who are residing in India are also eligible to apply. Persons with OCI Card are treated as Indian Citizens only.

2. To become a member, the applicant must complete the enrolment process and provide accurate and complete information. If any false information is provided, the Club may cancel the membership at any time without giving any notice and the fees or subscriptions paid shall be forfeited by the applicant/s.

3. The membership card will be issued once the information provided is validated and a thorough background verification conducted by the Club’s processing team which may include checking of criminal records, credit bureau reports, etc. The process may take minimum 15 days to maximum 120 days.

4. Upon completion of the verification process, if the documents of the membership applicant are found to be dubious, then the card will not be issued and a 15% fee shall be deducted towards administrative fees and 85% of the membership fee shall be refunded.

5. Members are facilitated to use their membership card only up to allowable trips in a calendar year of 365 from the day of issue of the card. Allowable duration for each trip shall be within the time limits of that respective category of membership.

6. Members have to submit their travel program through the Club's designated channels like through TOLL FREE TELELPHONE NUMBERS, WHATSAPP MESSAGE, MOBILE APP, EMAIL, and through our WEBSITE a minimum 48 hours prior to the trip. Members have to take the confirmation of booking of their trip and mere messaging or emailing or calling will not confirm their respective travel program. A Trip Identification Number (TIN) will be provided to each member after the trip is registered in the Club’s systems. If the TIN is not generated and provided to you, it is deemed that your trip is not registered in our system and you will have call our Customer Care again.

7. Cancellations will be accepted only till 48 hours prior commencement of travel program. Any request for cancellation of trip within 48 hours will make the member to forfeit one Electronic Coupon out of the allowable trips chances given per year.

8. Similarly, members, who used the cars beyond the allowable time window of that particular category of membership, will also lose one such chance out of the allowable trips given per year, in addition to levying one demerit point for such over usage of car.

9. The Club-provided vehicles shall not be misused for any illegal activities, or for carrying dangerous & toxic substances, whatsoever. If found in violation, then the complete liability shall be borne by the said member and hence the Club shall not have any such responsibility.

10. The Club will make reasonable efforts to ensure the accuracy of the information and services provided. However, The Club shall not be liable for any direct, indirect, incidental, or consequential damages arising from the use of our services.

11. While applying for a membership, the applicants/members indemnify and hold the Club, its employees, and agents harmless from any claims, liabilities, damages, costs, or expenses (including legal fees) arising from the use or misuse of ROXILLA EXECUTIVE TRAVEL CLUB (INDIA) LIMITED services or any violation of these Terms.

12. The Club reserves the right to terminate the membership at any time, with or without notice. Termination may result in the loss of all membership benefits and privileges, including the membership fee paid.

By applying for this Membership, you consent as follows: In this section ‘we/us’ means Roxilla Executive Travel Club (India) Limited and our related companies that assist us to provide our services and ‘you/your’ means all applicants/members named in this application. Purposes for which we collect, use and disclose your personal information

1) We collect, use and disclose your personal information:

to assess this application and future applications and to administer your travel facilities and related services;
to conduct reviews of your facility;
to comply with applicable laws both in India, including:
the National Consumer Travel Protection Act;
the Anti-Money Laundering and Counter-Terrorism Financing Act;
State and Territory property legislation and other property-related laws (for example, to register and search for security interests); and
for other purposes as listed in our Privacy Policy and our Travel Reporting Policy. If you do not provide us with the information we may not be able to assess your application or administer the products or services that you are seeking.

2) We usually collect your personal information directly from you. However, we may need to collect personal information about you from third parties for example, in order to assist us to process your application or to locate or communicate with you.

3) Where you have provided information about another individual, you must make them aware of that fact and the contents of this Privacy Consent and Notification, and have obtained their consent to make this disclosure to us.

4) Your telephone calls and conversations with a Roxilla Executive Travel Club (India) representative may be recorded and monitored for quality, training and verification purposes. Disclosures of your personal information

5) We may disclose to, and obtain personal information about you from:

Our affiliates, sales agents and organisations that carry out functions on our behalf including card schemes, mailing houses, data processors and marketing agents;
reward providers including Airline partners and their service providers;
other travel providers;
any signatory or guarantor to the facility for which you are applying;
any broker, introducer, financial, legal or other adviser acting in connection with your facility or application;
regulatory and tax authorities in India;
travel reporting bodies (see ‘Exchange of information with travel reporting bodies’ below);
any insurer relating to your facility;
organisations wishing to acquire an interest in any part of our business; and
as further set out in our Privacy Policy and Travel Reporting Policy.

Exchange of information with travel reporting bodies and other information services

6) If you have made an application for consumer or commercial travel, or have obtained consumer or commercial travel from us, you agree that we can obtain travel reporting information about you from a travel reporting body (CRB) for the purposes of assessing any application for consumer or commercial travel and collecting payments that are overdue in relation to consumer or commercial travel. You also agree that we can obtain, from any business providing information about commercial travel-worthiness, commercial travel reports about you for the purposes of assessing applications for consumer or commercial travel.

7) We may disclose personal information about you (including travel information, such as details about the travel that we provide to you, your membership history and any defaults) to, and obtain travel reporting information about you from, CRBs. Our Travel Reporting Policy contains information about travel reporting, including the CRBs with which we may share your personal information, their contact details, the type of travel reporting information we share, and your rights in relation to them. Our Policies (including how to access and correct information and make a complaint)

8) You can view our Privacy Policy or Travel Reporting Policy on our website at roxillatravelclub.com/privacy or obtain copies by calling us. These policies include information as to how you can access and/or seek correction of the personal information we hold about you. Our Privacy Policy and Travel Reporting Policy also contain information as to how you can complain about a breach by us of the Privacy Act (including the travel reporting provisions in Part IIIA and the Travel Reporting Code) and how we will deal with such a complaint. Your Marketing Communications Preferences

9) By completing this application you agree that we, our affiliate companies and their partners may use your personal information to keep you informed about offers relating to this product and other products, services and offers which may be of interest to you. They may do this by phone, mail, email and SMS or other electronic messages (without an unsubscribe facility). These consents operate indefinitely and shall remain in effect unless and until you notify us that you do not want to receive such communications. If you do not wish to receive these communications please notify us in writing or by calling us. Note: If you have not told us that you do not wish to receive these communications by phone, you may be contacted even if you have registered your phone number on the national Do Not Call Register.

Submit & Next