MEMBERSHIP APPLICATION FORM 20162016

 
Name:  
 
Postal Address: ,
 
Physical Address:
 
Telephone No: (H) (W)
 
Cell: Fax:
 
E-mail Address:
Family Details:
Name: ID:
Name: ID:
Name: ID:
Name: ID:
Name: ID:

 

Do you or your family have any medical condition or allergies that could affect your ability to hike:

MEMBERSHIP FEES 2016

  Total: R0.00  

INDEMNITY

I, the undersigned, apply for membership of the Footprint Hiking Club for 2016 and understand that I indemnify the club against all loss or injury while hiking or travelling to or from a hike or while involved in any club activity.

Signed: ....................................... Parent or Guardian (if under 18 years of age) ..................................

Date: Wednesday, October 26, 2016

                                                                                                                                           

 Instructions

If you are sending a cheque
Please make the cheque payable to: Footprint hiking Club and post to: 203 Robinbrook, 98 Oak Avenue, Robindale, Randburg 2194
Alternatively you can deposit the money directly into our bank account (when you pressed the send button your form was automatically submitted to us). Please let us have the signed copy of this form when you come on your first hike with the club.

Membership runs from 1 January to the 31 December of each year. People joining after 1st September automatically have their membership carried forward for the whole of the following year.

Bank account details

Footprint Hiking Club, Standard Bank, Southdale Branch 00-64-05

Account number 202425932

Please e-mail us your deposit slip: bookings@footprint.co.za

Thank you for your interest in our club