2026 Player Registration Form

2026 Registration Form
Phone: 0652278556/0733994540

TRAINING SESSIONS

Locations: CBC MOUNT EDMUND

Whatsapp group:

Basketball:https://chat.whatsapp.com/IZpnlBRJ8GhL4FTRSZY3UP

Hockey and Netball: https://chat.whatsapp.com/E549YcABCMXEcG8z0Kw0rY
Age group:
Pick one:
NAME & SURNAME

First NameLast Name
D.O.B

MonthDayYear
Gender:
PARENT / GUARDIAN OR NEXT OF KIN

First NameLast Name
PLAYER CONTACT DETAILS
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Medical information
Medical Aid / Insurance details:
Allergies:
Existing Injuries, disability or Conditions:
Medication Required:
I confirm that:

The medical information provided is accurate
I consent to emergency medical treatment if required
I understand and support the club/school safeguarding policy
I give permission for supervised travel to fixtures
For players under 18: I, the undersigned parent/guardian, give permission for my child to participate in training sessions, matches, transport, and club/school activities.
For senior players (18+): I, the undersigned player, consent to my own participation in training sessions, matches, transport, and club/school activities.
Emergency Contact Name

First NameLast Name
Emergency Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Once registered, you’ll be added to a whatsapp group for communication.
Fill in whatsapp number if different from the one above.
Bank Name: FNB Account

ACC NR:63145889747

Account type: Cheque Reference

Name and Surname
Release & Liability

In Consideration of my/our child being allowed to participate in any way for the Ditlou Titans Youth Sports team for the season, it's related events and activities, the undersigned acknowledges, appreciates, and agrees that:

RELEASE & LIABILITY AGREEMENT
In consideration of participation in Ditlou Titans Sports Association activities, the undersigned (parent/guardian or adult player) acknowledges and agrees that:

Participation involves risk of injury, including serious injury
I voluntarily assume all risks related to participation
I agree to follow all rules and instructions
I release and hold harmless DTSA, its officials, coaches, and representatives from any claims, injuries, or damages
Medical Clearance:
If a player leaves a session or match due to medical reasons, they may not return without clearance from a qualified medical professional. Coaches may request medical clearance at their discretion.

POPI ACT CONSENT
I consent to the use of photographs, video, or audio recordings taken during DTSA activities for promotional, documentation, or media purposes.
DECLARATION:I confirm that I have read and understand this form and agree to all terms and conditions.
Should be Empty:

2026 Registration Form

Phone: 0652278556/0733994540

TRAINING SESSIONS

Medical information