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MEMBER APPLICATION
To apply for our club membership, please take the time to fill out the information below.
SECTION 1: Personal Details
First Name (s)
Gender
Profession/Occupation
Last Name
Date of Birth
*
required
Mobile Number
Work Number (optional)
Nationality
Email Address
ID Number
Physical Address
Postal/Mailing Address
Medical Aid Scheme (optional)
Next of Kin (First Name & Surname) [to be contacted in case of an emergency]
Relationship with Next of Kin?
Choose an option
Next of Kin Contact Number
Doctor's Name (optional)
Know Ailments [these are imperative so that MHC can take appropriate action in the case of an emergency]
Allergies, Medication & Dietary Restrictions [these are also imperative so that MHC can take appropriate action in the case of an emergency]
Please give us a short biography of yourself (in not more than 50 words)
Please attach a headshot photo of yourself
Upload File
Upload supported file (Max 15MB)
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