Western Province Waveski Surfing Association

P.O. Box 11046, Bloubergrant, 7443

APPLICATION FOR MEMBERSHIP

I hereby make formal application for membership to the W.P. Waveski Association and shall abide by the constitution of the Association. Furthermore, in consideration of your acceptance of my application, I hereby release the sponsors and the event/competition organisers from any liability for injury or damages whatsoever arising from my participation or presence at any club or association event. Release is inclusive for photographs and motion pictures and I further agree to co-operate with sponsors and organisers to the mutual benefit of all concerned and for the promotion of the sport.

Full first names:__________________________________________________________

Surname:_____________________________ ID No.:___________________________

Address: _________________________________ Date of Birth:___________________

__________________________________Tel No: (H)____________________

__________________________________ (W)____________________

________________ Code:_____________ (Fax)___________________

Occupation:________________________________ (Cell)___________________

Type of membership Competitive Social

Type of membership - tick appropriate box