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Full Name *
Student Number *
e.g. 45671234 (8 digitise, no 's' in front)
Phone Number *
Lifegroup *
 The group you are joining or the person stated above is in. Feel free to ask if you are unsure.
Disclaimer of Liability: *
I hereby declare that the particulars given by me are true and correct. I hereby agree to indemnify Campus Christian Movement (CCM) and its committee members against all claims or actions for any loss, damage or injury whatsoever or howsoever arising in relation to CCM activities.
Required
Photo and Video Disclaimer: *
CCM reserves the right to use any photograph/video taken during events in publications or other media material produced, without the expressed written permission of those included within the photograph/video.
Required
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