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)
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Full Names *
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Preferred Name *
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Demographic Profile *
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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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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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