Hawkwind Hang-gliding

and Paragliding Club

Hawkwind Hang-gliding

and Paragliding Club

Designed and Created by Cal Dyker

Membership Application and Renewal Form: 2005/6

Personal Details:

First Name

Last Name

Residential Address

Postal Address

Postal Code

E-mail Address

Date of Birth DD MM YYYY

Contact Details:

Telephone: Home Code

Work Code

Cell

Person to call in an Emergency Name

Telephone Home Code

Work Code

Cell

Licence and Glider Details:

HG or PG Licence Grade

SAHPA Membership Number Licence Number

Glider Manufacturer Model Size

Main Colours of Glider

Declaration:

I wish to of the Hawkwind Hang-gliding and Paragliding Club. I agree to abide by the Constitution Rules and Regulations of the Club as may be in existence from time to time.

Print Name as on line signature

Date

Consent of Parent / Legal Guardian for person under 18 years old

Print Name as on line signature

Date

Membership Fees for Period 1 July 2001 to 30 June 2002

Entrance Fee (New Members Only)

R 50-00

Annual Membership	R 100-00
or

Country / Student Membership	R 60-00
Family Membership: each additional member	R 60-00

Please submit all completed forms and Payments to :	The Treasurer
	Hawkwind HG and PG Club
	4 Stonehedge Crescent
	Beverly Grove , P.E.
	6070

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First Name
Last Name
Residential Address

Postal Address
	Postal Code
E-mail Address
Date of Birth	DD MM YYYY

Telephone:	Home	Code
	Work	Code
	Cell
Person to call in an Emergency	Name

Telephone	Home	Code
	Work	Code
	Cell

Licence Grade

SAHPA Membership Number

Licence Number

Glider Manufacturer

Main Colours of Glider