MEMBERSHIP APPLICATION/ RENEWAL FORM FOR 2016

Full Name: (Main Member)
I.D. Number:
Postal Address
Code
 
Street Address
 
Telephone (H)
Telephone (W)
Fax:
Cell:
E-mail:
 
Family (If joining as family member)
 Names:



ID Numbers:



 
Do you or any of your family have any medical conditions or allergies that could affect your ability to hike?
If Yes please describe:
 
MEMBERSHIP FEES FOR 2016
 
Joining Fee (once-off-payment) R25.00
Annual Individual Membership R100.00
Annual family Membership R120.00
 

Indemnity

Hiking as with any other sports and pastimes has certain risks attached to it. While Footprint Hiking Club endeavours to ensure the safety of all its hikers, it does not take responsibility for any loss or injury incurred while the participant is partaking in a club activity or travelling to such activity. You participate entirely at your own risk. By submitting this form you accept the above conditions.

Banking details:

Footprint Hiking Club

Standard Bank of South Africa,

Southdale Branch 00-64-05

Account number: 202425932

 

Postal and physical address:

Footprint Hiking Club

203, Robinbrook

98, Oak Avenue,

Randburg 2194

Footprint Hiking Club

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