Register Child Member - Rock n Rut Mountain Bike Club

Your Email (Main/Parent Member)*

Child Member can be registered and managed by Main/Parent Member
Username*

Please create username, child member can login with only username and password without email.
Hidden
Generated Email*
Password*
Enter Password Confirm Password
Full Name*
First Last
Date of Birth*
DD slash MM slash YYYY
Postal Address
Town*
ID/Passport Number
Cell
Telephone Home
Emergency Contact Name*
Emergency Contact Number*
Medical Aid Name
Medical Aid Number
Blood Group
Allergies
Membership Information
Membership Type*
Category*
First and Surname of Main Member*
Proof of Payment
Max. file size: 250 MB.
Payment via
Hidden
Payment Date
DD slash MM slash YYYY
Indemnity*
- I have read and agree to the terms and conditions of the indemnity agreement.
Constitution Read*
- I have read and agree to constitution
Mailing List (optional)
- I want to receive updates from Rock & Rut
Membership Code
* Your membership request will be sent to admin for verification.
Name
This field is for validation purposes and should be left unchanged.

Membership Information