When – May 4, 2019
Where – Northgate Ice Rink
Time – 17:30
Date of birth
—Please choose an option—femalemaleother
I am applying for:
—Please choose an option—Introductory SynchroBronze SynchroAdult SynchroNovice SynchroJunior Synchro
I have attempted this before:
—Please choose an option—YesNo
—Please choose an option—Bambelela Blades FS ClubEgoli FS ClubOther (Please Specify)
—Please choose an option—Eastern CapeFree StateCentral GautengGauteng NorthKwazulu-NatalLimpopoMpumalangaNorth-WestNorthern CapeWestern Cape
—Please choose an option—Division ADivision B
—Please choose an option—SOLOPAIRSICE DANCE
—Please choose an option—Juvenile Girls/BoysPre-Novice Girls/BoysNovice Girls/BoysJunior Ladies/MenSenior Ladies Men
—Please choose an option—Chicks girls/boysSparrows girls/boysBronze Hawks girls/boysBronze Hawks Club girls/boysSilver Falcons Girls/BoysSilver Falcons Club Girls/BoysGolden Eagle Ladies/MenAdults Beginners Artistic Ladies/menAdults Beginners Technical Ladies/menAdults Advanced Artistic LadiesAdults Advanced Technical Ladies
—Please choose an option—ABCD
Type A-athlete is a South African citizen regardless of where he or she may train or reside.
Type B-athlete is a South African permanent resident or a South African temporary resident who has been a permanent or temporary resident of South Africa for more than one (1) year and who can provide proof that he/she has been resident in South Africa for more than six (6) months in the twelve 12-month period immediately preceding the holding of the competitive event.
Type C - athlete is a South African temporary resident who has been a temporary resident of South Africa for more than one (1) year and who cannot provide proof that he/she has been resident in South Africa for more than six (6) months in the twelve 12-month period immediately preceding the holding of competitive event.
Type D - athlete is neither a South African citizen nor a South African permanent or temporary resident and therefore does not fall in the preceding competitor classifications of Type A or Type B.
I have read and agree to the terms below
By submitting the above form, you understand and agree that SAFSA and CG FSA shall not be liable for any injury or loss occasioned by the athlete while travelling to or from or during the competition, nor SAFSA-Central Gauteng FSA be responsible for any damages or losses caused by the athlete during the same time.
The athlete and/or athlete’s parent(s)/legal guardian agree to indemnify SAFSA-Central Gauteng Figure Skating Association and hold them harmless from any claims or demands in respect of such loss or damage.
The competitor as indicated in the form above hereby acknowledges and consents to the fact that SAFSA-Central Gauteng Figure Skating Association Provincial Competition will be videotaped either in whole or in part.
The competitor hereby consents to the use of his/her name, biography and likeness on or in connection with any television or radio program, motion picture or still pictures, video, new media, internet, web, print media or the advertising and publicizing of such program as may be designated by SAFSA-Central Gauteng Figure Skating Association and waives all the rights to remuneration or otherwise in connection with the above.
The foregoing is subject to assurance that the eligibility of the competitor will be fully protected by SAFSA-Central Gauteng Figure Skating Association.