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Top Out Climbing Club Member Registration
Please complete the below in order to become a member of Top Out Climbing Club.
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* Indicates required question
Email
*
Your email
Member First Name
*
Your answer
Member Second Name
Your answer
Member Surname
*
Your answer
Member ID Number
Your answer
Parent/Guardian 1 Name and Surname
*
Your answer
Parent/Guardian 1 Cellphone Number
*
Your answer
Parent/Guardian 1 Email Address
*
Your answer
Parent/Guardian 2 Name and Surname
*
Your answer
Parent/Guardian 2 Cellphone Number
*
Your answer
Parent/Guardian 2 Email Address
*
Your answer
Physical Address
*
Your answer
Postal Address
*
Your answer
Medical Aid Provider
Your answer
Medical Aid Main Member Name and Surname
Your answer
Medical Aid Main Member Cellphone Number
Your answer
Medical Aid Main Member Email Address
Your answer
I have paid the R100 Top Out Climbing Club Annual Membership Fee
*
Yes
No
I have registered as a member of Western Cape Climbing
*
Yes
No
I have registered as a member of the South African National Climbing Federation
*
Yes
No
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