Online Membership Application Form

Fields marked with an * are required

SURNAME *

FIRST NAME *

DATE OF BIRTH *

ID / PASSPORT NUMBER

POSTAL ADDRESS *

PHYSICAL ADDRESS

HOME TELEPHONE NUMBER

WORK TELEPHONE NUMBER

CELLPHONE NUMBER *

FAX NUMBER

EMAIL ADDRESS *

I actively participate and would like to represent the club in the following sports below. Please note additional levies may apply to some of the sporting sections.

Your personal information provide by you will be used and processed as is necessary to actions and functions for the conclusion or performance of the agreement entered into between the parties. The personal information will be provided to all third parties should it be required while conducting business for this specific purpose. The confines of the agreement will not be overstepped and the documentation collected and/or personal information given will not be used for any other purpose other than that of the performance of the agreement unless otherwise required by law or prior authorization is obtained.

TERMS AND CONDITIONS:

1. *

I agree that the submission of this application for membership shall be a distinct acknowledgement on my part that I am bound by the Constitution and Rules, Regulations and By-laws of the Club and Sub-clubs, which are now or which may be in force hereafter and that I accept the rulings of the Committee in all cases, and that I will not be absolved from the effect thereof on the grounds of not having received a copy of any of them.

2. *

I acknowledge that the Club cannot be held responsible or liable for any loss or damage to my property or possessions arising out of theft or any cause whatsoever, or for any personal injury sustained.

3. Have you previously been a member of The Wanderers Club? *

4. If yes please provide a date when your membership terminated

5. Please provide reasons for membership termination

6. Please provide a parents or guardians name if this application is for junior membership

7. Have you previously had your membership withdrawn or rejected from any club? *

8. Please provide reasons for your membership withdrawal or rejection

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