Join the Purple Team! Hollywood AC Registration 2023 Hollywood AC Registration 2023 Register Online and join us in 2023! Please ensure all information is correct Identification * Identity Document Birth Certificate Passport Refugee Permit Enter identification number or other relevant number * ASA Province KZNA Central Gauteng Gauteng North Free State Eastern Cape Title (Mr,Mrs,Ms,Dr etc) * First Name * Surname * Gender Male Female Laser Cut Vest Size * XX- Small X- Small Small Medium Large X- Large XX- Large XXX- Large T-shirt Size * Extra Extra Small Extra Small Small Medium Large Extra Large Extra Extra Large Email * Street Name and Number * Suburb * Province * Cell Number * Alternate Number Emergency Contact Name * Emergency Contact Number * Indemnity: DECLARATION I declare that I am a bona fide athlete/coach/technical official/office bearer I confirm that all the information provided on this application is true and correct I understand that my participation in an athletics related event is subject to the ASA Constitution, its rules and regulations I understand that this licence can be retracted should I violate the ASA Constitution, its rules and regulations I hereby accept that I participate in any event of ASA and its members entirely at my own risk I indemnify ASA and its members, sponsors and organisers of any event against all and any action of whatever nature which may arise out of my participation and I agree that it is my responsibility to be medically fit to compete in any event I understand that my information may be shared with ASA partners, in accordance with the ASA Privacy Policy I understand that if I am a minor, my parent and/or legal guardian understands the nature of the athletic activity, approve of the declaration above, and sign it on my behalf Indemnity Declaration Acceptance * I have read and understood the above declaration and agree Submit and Join the PURPLE Team! If you are human, leave this field blank.
