Vertex Movement
REGISTRATION
Athlete Application
ATHLETE DETAILS
First Name
*
Last Name
*
Middle Name
Athlete that referred me
Gender
*
-- select gender --
Male
Female
non-Binary
Ethnicity
*
-- select ethnicity --
African
Asian
Caucasian
Coloured
Indian
Middle Eastern
Other
Date of Birth
*
Home Language
*
Select an option
Afrikaans
English
French
Dutch
German
Xhosa
Zulu
Other
Nationality
*
Type of Identification
*
-- select --
Birth Certificate
South African ID Document
International Passport / Permit
Identification Number
*
Account Responsibility
*
-- select --
Athlete
Guardian/Parent
GUARDIAN/PARENT DETAILS
If the athlete is a minor (Under 18) then a guardian/parent needs to fill in this section.
First Name
*
Last Name
*
Guardian Email
*
Guardian Mobile Number
*
Type of Identification
*
-- select --
Birth Certificate
South African ID Document
International Passport / Permit
Identification Number
*
Relationship to Athlete
*
ATHLETE CONTACT DETAILS
Mobile Number
*
Emergency Contact Number
*
Email
*
YOUR ADDRESS
Address Line 1
*
Address Line 2
*
Suburb
*
City
*
Post Code
*
Country
*
SKILLS & EXPERIENCE
List any previous experience you have that may be relevent..
MEDICAL INFORMATION
Any medical conditions?
*
Any medication or allergies
*
TERMS AND CONDITIONS
Full Terms and Conditions Contract and Waiver will be available on next page. This must be signed and returned to: applications@vertexmovement.com with your Full Name as reference for your application to be completed.
I agree that the information provided above is true, up to date and correct.
Any personal information shared in relation to this application will only be used for purposes directly related to fulfilling the obligations of this application and will not be disclosed to third parties without prior consent, unless required by law.
