Member Registration Form – Evertsdal Squash Club

Membership Application Form

Please complete the form below to submit a membership application to Evertsdal Squash Club. You will receive a reply email providing further details.

Main Member Name(Required)

Prefix First Last

Date of Birth(Required)

Main members date of birth

ID Number(Required)

Main members ID Number

Email(Required)

Main members email address

Enter Email Confirm Email

Mobile Phone(Required)

Main member mobile phone number

Address(Required)

Street Address Address Line 2 City Province Postal Code Country

Occupation

Emergency Contact Person(Required)

First Last

Emergency Contact Mobile Phone(Required)

Please select one or more of the following options(Required)

Social squash only (no interest in league)

Currently playing league squash

I would like to participate in league squash for EVT

Based on your reply, you will be contacted about joining one of the EVT league teams.
If you want to make contact with Chris Goslin, our Club Captain, please contact him via WhatsApp

Additional Family Members

Not applicable (main member only)

Spouse / Partner

Student (School / Varsity)

Senior (65+)

Spouse / Partner

Name

Prefix First Last

Relationship to main member

2nd Adult Date of Birth

2nd Adult ID Number

2nd Adult Mobile Phone

2nd Adult Email

Student

Scholar Name

Prefix First Last

Scholar Date of Birth

Senior

65+

Senior Name

Prefix First Last

Senior Date of Birth

Membership Application Form

Spouse / Partner

Student

Senior

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