Membership Registration Form – Habibia Archery Club

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Membership Registration Form

All Members are required to fill out individual membership form

General Information

Full Name

Gender *MaleFemale

Date of Birth *

Month

Day

Year

Age *

Ethnicity ( For Statistical Purposes Only )WhiteBlackColouredIndianMixedOther

Email Address *

Phone *

Relevant Medical Information

Do You Have Any Medical Conditions And/Or Disabilities?YesNo

Please List Any Relevant Medical Conditions And/Or Disabilities

Related Archery Information

CategoryBarebowRecurve(Sight)Compound

Are You A Member At A Secondary Club?YesNo

Additional Club Memberships

Name of the 'Other' Club

SANAA INFORMATION

Are You SANAA RegisteredYesNo

SANAA Memebership Number:

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