let us know about you!! I am a:(Mark all activities relevant) Athelete Coach Technical Official Office Bearer Discipine: (Mark all activities relevant) Track & Field Road Running Off-Road Running Race Walking Demographics - SRSA Requirement : Black Coloured Indian White Age category- SRSA Requirement : Senior+ Junior High School Primary School Sex: Male Female DOB: This field can not left blank. Select your Interests: Run Walk Cross Country Track & Field Social Title(Mr/Ms/Dr./ect.) : This field can not left blank. Initials : This field can not left blank. Surname: First Name: This field can not left blank. This field can not left blank. Type of Identification Document : ID Book/Card Birth Certificate Passport Refugee Permit Identification Number This field can not left blank. ASA Identification Details ASA Province This field can not left blank. 2023 License Number : This field can not left blank. 2024 License Number : This field can not left blank. Club Name (in full) : This field can not left blank. Address Details Residential Address: This field can not left blank. Postal Code: This field can not left blank. Postal Address: Postal Code: All correspondence to be sent to: Residential Address Postal Address Tel. No. 1 : This field can not left blank. Tel. No. 2 : This field can not left blank. Email Address : This field can not left blank. Occupation No. : Next of Kin Name This field can not left blank. Tel. Number 1 : This field can not left blank. Tel. Number 2 : This field can not left blank. I declare that I am a bona fide athlete. I confirm that all the information provided on this membership form is true and correct. I subject myself to the rules and regulations of Durban Athletic Club, KwaZulu-Natal Athletics and Athletics South African and indemnify the aforementioned bodies against all and any action whatever nature which may arise out of my participation in any club affairs, road race, cross country or track events. I agree it is my responsibility to be medically fit to compete in any event.