Club Registration Form

Name and Surname*

Email Address*

Identity Number*

Cell Number*

Date of Birth*

Upload ID photo*

Declaration:

1. I understand that to establish my eligibility, I must submit my data to SARLSA, of my own violation and that SARLSA must process that data in order for me to be an active participant/member in local and/or international rugby league activities.

2. I understand that SARL has the right to store my information in line with its privacy policy and consent to it doing so

3. I agree to be bound by the SARL Operational Rules, Code of Conduct, Constitution and any amended version of the above subsequently to the submission of this form

4. I hereby agree to adhere to the International Rugby League Policies and Rules & Regulations

Please Select To Accept*

I Accept

Membership Allocation*

Emergency Contact Person*

Emergency Contact Number*

Medical Aid Provider & Number*

Guardian Details (if you are under 21)

Home Address*

Home Contact Number

Place of Residence*

Which Club do you play for?*

Position you play?*

On completion of all the Membership Registration Form Criteria & by submitting the application evidence-On completion of all the Membership Registration Form Criteria & by submitting the application evidence-I hereby indemnify the South African Rugby League Board and affiliates against any claim that may arise from any of the following:

Acts of God.

Vehicle accidents enrooted to and from playing venues.

Loss of goods during matches/practises.

Financial loss due to my participation as an amateur player.

Financial loss during matches/practises.

Injuries during practises or matches playing at Mini League-, Junior League-, Club-,Regional-, Provincial, National-, or International-level.It is hereby recorded that I the above person is an amateur Rugby League player/member - and it is an expressed condition that I must have my own medical scheme for my medical expenses.

The obligation rests entirely with the player/member to ensure that the above condition have been fulfilled and the player/member hereby holds the SARL Board and affiliates blameless for any medical or other costs that may be incurred due to non-compliance

Please Select To Accept*

I Accept