ONLINE ENTRIES ARE OPEN FOR 2012 GAS DH CLUB MEMBERSHIP

Please fill in the required information in the form below and then submit it to GAS. Then please pay your CLUB MEMBERSHIP of R300 without full CSA race licence, or R250 if you will also sign-up for full CSA race licence on the CSA website into the Club's bank account and use your letter of firstname and 3 letters of surname + Cellphone number as your Reference. Your club membership will be confirmed once your correct data has been received and payment has been verified.

Our Bank Details are as follows:
Bank: First National Bank
Type: Cheque Account
Account Number: 62245699923
Branch: Clearwater Wall
Branch Code: 251141

INDEMNITY WAIVER

1. I hereby waive whatever claim/s I may have at any time and howsoever arising against Gravity All Stars DH MTB Club – (GASDH) and/or it's officials/members, employees, servants, agents, assistants and the organisers of any cycling event at which I may compete, held under the auspices of Cycling SA or GASDH in respect of or arising out of, whether directly or indirectly, any event held by or under the auspices of  Cycling SA or GASDH for any bodily injury which I may suffer or any damage to any property which I may have legal interest, whether such damage or loss or injury was caused partly or wholly by the negligence albeit gross on the part of any one or more of the parties referred to above or any part for whom they may be vicariously liable.  
2. I likewise hereby irrevocably and in ram suam appoint GASDH as my agent on my behalf to waive any claim or claims which I may have at any time, of the kind set out above, against any Provincial, Municipal or other local authority or land owner from whom permission must be obtained for the lawful holding of any event, it's officials, servants, agents and assistants, upon the same terms and conditions as are set out herein.
3.  I hereby undertake that I shall at all times hold GASDH in particular and all parties referred to above including private land owners, harmless and keep it indemnified against all action/claims/demands/costs and expenses, arising out of any event mentioned in which I may compete in or during any training session.

Applicable to all minors under the age of 21
The Parent/Guardian need to consent to the minor making this application upon the terms and conditions therein contained and agree to be bound by the said terms and conditions.  The Parent/Guardian verify the minor's date of birth and if called upon to do so, will furnish a copy of the relevant birth certificate.

A seperate confirmation from the Parent/Guardian will be requested as part as the membership processing.