Membership registration
Please complete all the fields and email proof of payment to chessclubcenturion@gmail.com (Banking Details on previous page and we also accept SnapScan payments)
Surname
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Full Names
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Preferred Name
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Demographic Profile
Gender
Language Preference
Date of Birth
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ID Number
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Chessa ID
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Rating
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Email
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Cell Phone Number
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Alternative Cell Phone
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Membership type
Participation in Club Activities
School / Tertiary Institution (if applicable)
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Suburb / Town (where you live)
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Which Social Media / Communication platforms would you prefer
Comments
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I commit myself to the principles, rules and regulations contained in the Constitution of the Centurion Chess Club: http://www.centurionchessclub.co.za/home/membership/constitution
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