Helderberg Harriers Membership Form
* Required
Membership Application Type
*
New Membership
Renewal of Membership
Surname
*
Your answer
Full Birth Name (s)
*
Your answer
Casual Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
ID Number
*
Your answer
Telephone Number (Home)
*
Your answer
Cellphone Number
*
Your answer
Telephone Number (Work)
*
Your answer
Email Address
*
Your answer
Postal Address
*
Your answer
Residential Address
*
Your answer
Please indicate preferred communication language
*
English
Afrikaans
What is your home language (or home languages)
*
Your answer
What is your present occupation / job / status?
*
Your answer
We need each Helderberg Harriers member to help or support the club with SOMETHING during the course of this year, please indicate and or complete
*
I can assist with the Spookhill 15km Race
I can assist with the Winelands 21km/42km
Required
Membership Category
*
Choose
Normal Member (HH Club Fee R160 + ASA License Cost R50 = R210)
Family Member (HH Club Fee R80 + ASA License Cost R150 = R130)
Junior Member (HH Club Fee R10 + ASA License Cost R30 = R40)
Social Member (HH Club Fee R80 + ASA License Cost R0 = R80)
Honorary Member
Helderberg Harriers RUNNING GEAR (Compulsory)
*
HH Running T-shirt @ R230
HH Running Vest @ R200
Red Shorts @ R140
No Clothes Needed
Required
Banking Details for direct deposit / EFT payment:
Account Name: Helderberg Harriers
Account No: 62804453851
Bank: First National Bank
Use your NAME & SURNAME as reference
Application Checklist: Please check that you have completed the necessary steps:
*
Register with ASA via
http://asa.saclubs.co.za/
, if not yet registered
Complete compulsory ASA application form and email it to
info@helderbergharriers.co.za
Send copy of ID if Junior to
info@helderbergharriers.co.za
(under 19 years old) must provide a colour copy of ID document (Strict WP Rule)
Send proof of Payment to
info@helderbergharriers.co.za
: Licence numbers will only be provided when proof of payment is received
I paid using SnapScan
Required
Please read carefully and agree to the following terms and conditions
*
I undertake to abide by all the club rules and club decisions
I undertake to abide by all the rules of ASA and WPA
Required
Submit
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