BLACK DIAMONDS

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PLAYER
REGISTRATION

Join the Black Diamonds Netball Club

Membership Registration

PLAYER INFORMATION

Player’s First Name *

Player’s Surname *

Date of Birth *

PARENT / GUARDIAN DETAILS

Relationship to Player *

Your Email Address *

Parent *

Mother Father

Full Name (Name & Surname) *

Contact Number *

Email Address *

Relative

Grandparent Uncle Aunt Sibling

Please indicate your relationship to player

Phone Number *

Is this the emergency contact? *

Please indicate your relationship to player

Phone Number *

Is this the emergency contact? *

EMERGENCY CONTACT

Full Name *

Phone Number *

Email *

MEDICAL INFORMATION

Any medical conditions? *

Yes No

Any allergies? *

Yes No

PLAYING POSITION

Preferred Playing Position *

What informs this choice? *

PAYMENT INFORMATION

Joining Fee: R700 (once-off)

Monthly Membership: R500 per month

Please use the player’s name as reference when making payment.

Account Holder: Martha K Nkoana

Bank: Capitec

Account Number: 2542547420

Branch Code: 470010

Account Type: Savings

Reference: Player Name & Surname

DECLARATIONS & CONSENT

I agree to the Indemnity & Participation Agreement I accept all financial obligations (R700 joining + R500/month) – Financial Obligations I grant media consent as per the Media Consent Policy I agree to all club rules regarding attendance, selection, and conduct

Electronic Signature (Full Legal Name) *

By typing your name, you confirm that this is a legally binding electronic signature.