APPLICATION OF MEMBERSHIP (2016)

The Chairman; Run4Christ Athletics Club

Surname: Click here to enter text.	Name: Click here to enter text.
Date of birth: Choose an item. Choose an item. Click here to enter text.	ID number: Click here to enter text.
Postal Address: Click here to enter text. Click here to enter text. Click here to enter text. Postal code:Click here to enter text.	Postal Address: Click here to enter text. Click here to enter text. Click here to enter text. Postal code: Click here to enter text.
Telephone numbers: Click here to enter text. (h) Cellular Number: Click here to enter text.	Click here to enter text. (w) Facsimile number: Click here to enter text.
E-mail address: Click here to enter text.	Gender: Choose an item.
If you are a junior member – Which school / university do you attend:	Click here to enter text.
Senior members: Where do you work:	Click here to enter text.
I wish to participate in: Road running: ☒ Cross Country: ☐ Track & Field: ☐
Clothing sizes: Shorts: XL Vest: M Croptop: L
☒ I hereby declare that I will abide by the rules and the constitution of the Run4Christ Athletics Club, Eastern Cape. Club Contact Nrs: Kiri Barnard: 073 556 7115 Attie Williams: 083 293 0202

After completing the form mail it back at: attie.williams@prasa.com to complete registration. Thanks, Run4Christ Group.