KYP Membership Registration Form

KYP Membership Registration Form
Youth Name

First NameLast Name
Age
ID no
RSA ID no/ Passport no
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School
Grade Level
Arts and CultureBusiness DevelopmentEducation supportDignity Matters
Does the youth have any allergies?
Does the youth have any medical conditions that we should be aware of?
Parent/Guardian Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
Payment Details
Fee
prevnext( X )
Registration Fee
The registration fees cover the cost of enrollment to our programs for 12 months

100.00ZAR

Monthly Donation
Our monthly subscription is at a call of responsibility where each day the beneficiary is asked for R 1 or a R 31.00 monthly contribution. This is our way to create a community of participative development where the organisation is working together with the community to enrich the youth.

31.00ZAR Quantity

Total

0.00ZAR
Acknowledgment
- I agree to follow the guidelines, rules, and policies of the organisation.
- If a chaperone or driver is needed, I'll do that.
- I allow my child to be photographed or be part of the video that will be used for marketing, promotion, and advertisements.
- The repeated offense of the youth may result in suspension or expulsion.
- Parent/Guardian registered in this form has legal custody over the child.
- I allow my child to ride any vehicle that is related to the organisation activities provided that there's an adult on board.
- For medical emergencies, I allow the medical team of this organisation to take care of my child.
- I release this organisation from any and all liability from accident or injury to the child during the organisation related events.
Parent/Guardian Signature

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Date Signed

MonthDayYear
Date
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KYP Membership Registration Form

Parent/Guardian Information

Payment Details

Acknowledgment