Club Registration Application Form
CLUB AFFILIATION APPLICATION FORM – 2013
Name of Club |
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Province |
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Club Postal Address |
Code: |
Club Physical Address |
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Telephone No. of Club |
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No. of Initial Club Members (min 10): |
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Disciplines Available (lead &/or bouldering and/or speed) |
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Club Facilities Available: (e.g. Clubhouse etc). |
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Club colours (Describe Club colours). |
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1. PRESIDENT’S DETAILS |
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Name: |
Tel No: (W) |
Fax No: |
Cell: |
Email: |
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Postal Address:
Code: |
2. VICE PRESIDENT’S DETAILS |
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Name: |
Tel No: (W) |
Fax No: |
Cell: |
Email: |
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Postal Address:
Code: |
3. SECRETARY’S DETAILS |
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Name: |
Tel No: (W) |
Fax No: |
Cell: |
Email: |
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Postal Address:
Code: |
4. TREASURER’S DETAILS |
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Name: |
Tel No: (W) |
Fax No: |
Cell: |
Email: |
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Postal Address:
Code: |
Climber Fees for 2013 (per member):
Western Cape Climbing: R 40-00
SANCF: R120-00
Total Due: R160-00
Climber fees can be paid directly into our bank account
Western Cape Climbing
Bank: FNB
Branch: 204209
Account No: 62380592652
Cheque Account
Signed: ________________________________________________ Date: __________________________________
PLEASE ALSO SUBMIT A COPY OF YOUR CLUB CONSTITUTION AND FOUNDING RESOLUTION |