Registration form

Year:

Nelson Mandela University Student / Staff Number:

ID/Passport Number:

Please select:

Title:

Initials:

First Name:

Surname:

Contact Number:

Email Address:

Gender:

Date of Birth:

Address in Port Elizabeth (Current residential):

Address (if you are not from Port Elizabeth):

Population Group:

School Attended:

Campus attending classes:

Course studying:

All students, staff and community members are eligible to join according to the specific sport club regulations and constitution.

PLEASE INDICATE THE CLUB(S) YOU WISH TO JOIN BY PLACING AN “X” IN THE APPROPRIATE AREA

• Students do not pay Membership Fees for these sport clubs

• PLEASE TAKE NOTE: SOME CODES eg Football, Hockey students will pay a membership release / exit fee when requesting CLEARANCE CERTIFICATES. R150 for non-bursary holders and R300 for (ex-) & current bursary holders. This is an administrative fee in lieu of free club subscription, free regional and / or national registrations and general club operational cost. Exit Fees are payable at Mandela University Cashiers in respective Cost Centres. Please enquire from respective codes sport managers about clearances from Mandela University sport clubs.

• I indemnify the Mandela University against any claim arising out of any injuries, loss or illness suffered or contracted by the applicant, myself or any third party representing myself or the applicant during the course of or arising out of his\her participation in sporting activities at the Mandela University irrespective of the cause of such damages, illness or loss.

• ​The Protection of Personal Information Act, 2013 (POPI Act) has been promulgated and implemented on 1 July 2020. All personal identifiable information provided by you shall be treated in accordance with this statute and only be used for sport and sport administration purposes, as indicated in the University Privacy Policy. I hereby provide consent of all my personal identifiable information provided to the University for the aforesaid purposes

 

 

 

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