FREE STATE Important InformationFinal date for Member Registration for 2024: 31 March 2024.Applications without supporting documentation as below, will not be processed.Membership Certificates for 2024 will be issued at the first next competition after submission of registration form.Member number will be issued to member after completion of registration.First Name *Last Name *2024 Cloth Number:ID Number *0 / 13LandlineCell PhoneEmail AddressPARTNER CONTACT DETAILSContact details for CURRENT PARTNER (on the same Cloth #) of the above Member.First Name *Last Name *2024 Cloth Number: *ID Number *0 / 13Membership Categories *Please select an optionGeneralClubOfficialAssociate MemberGeneral *Please select an optionYouth, Adult & Senior over 16 years e.g. parent, dancer, administrator, general memberJuvenile, Junior under 16 Years e.g. dancer, general memberSubscription Fee 2024Paid by 31 March 2024RSubscription Fee 2024Paid by 31 March 2024RSubscription Fee 2024Paid by 31 March 2024RSubscription Fee 2024Paid by 31 March 2024RSubscription Fee 2024Paid AFTER 31 March 2024RSubscription Fee 2024Paid AFTER 31 March 2024RSubscription Fee 2024Paid AFTER 31 March 2024RSubscription Fee 2024Paid AFTER 31 March 2024RSubscription Fee 2024Supporting Documents RequiredCopy of ID/PassportSupporting Documents RequiredCopy of Birth CertificateSupporting Documents RequiredComplete and submit separate Club Registration form and feeSupporting Documents RequiredCopy of ID, ALSO complete and submit DTO Accreditation formSupporting Documents RequiredPlease provide credential letterDetails of Registered Club(s) / School(s) / Studio(s) under whose name(s) the member will be competing in 2024Are you a Club, Studio or School? *Please select an optionClubStudioSchoolWhat type of dance business are you?Ballroom/StandardClub NameSchool NameStudio NameClub Manager / HeadStudio Manager / HeadSchool Manager / HeadClub Manager Cell PhoneStudio Manager Cell PhoneSchool Manager Cell PhoneCoach First NameCoach Last NameCoach Cell PhoneCoach Email AddressLevel member wishes to dance:Level 1Level 2Level 3Level 4Rising StarChampionshipProfessionalOpen MedalLatin-AmericanIs the Club / Studio / Club Information the same as above?Same as aboveNoDo you attend a different club / studio / school.Club Name *Studio Name *School Name *Club Manager / HeadStudio Manager / HeadSchool Manager / HeadClub Manager Cell PhoneStudio Manager Cell PhoneSchool Manager Cell PhoneCoach First NameCoach Last NameCoach Cell PhoneCoach Email AddressLevel member wishes to dance:Level 1Level 2Level 3Level 4Rising StarChampionshipProfessionalOpen MedalProvince *Please select an optionEastern CapeFree StateGautengKwa-Zulu NatalLimpopoMpumalangaNorthern CapeNorth WestWestern CapePlease select the province you are located in?Eastern Cape District *Please select an optionBuffalo City MetropolitanNelson Mandela Bay MetropolitanAlfred Nzo DistrictAmathole DistrictChris Hani DistrictJoe Gqabi DistrictOR Tambo DistrictSarah Baartman DistrictPlease select the district you are located in?Free State District *Please select an optionMangaung MetropolitanFezile Dabi DistrictLejweleputswa DistrictThabo Mofutsanyana DistrictXhariep DistrictPlease select the district you are located in?Gauteng District *Please select an optionCity of Ekurhuleni MetropolitanCity of Johannesburg MetropolitanCity of Tshwane MetropolitanSedibeng DistrictWest Rand DistrictPlease select the district you are located in?Kwa-Zulu Natal District *Please select an optioneThekwini MetropolitanAmajuba DistrictHarry Gwala DistrictiLembe DistrictKing Cetshwayo DistrictUgu DistrictuMgungundlovu DistrictuMkhanyakude DistrictuMzinyathi DistrictuThukela DistrictZululand DistrictPlease select the district you are located in?Limpopo District *Please select an optionCapricorn DistrictMopani DistrictSekhukhune DistrictVhembe DistrictWaterberg DistrictPlease select the district you are located in?Mpumalanga District *Please select an optionEhlanzeni DistrictGert Sibande DistrictNkangala DistrictPlease select the district you are located in?Northern Cape District *Please select an optionFrances Baard DistrictJohn Taolo Gaetsewe DistrictNamakwa DistrictPixley Ka Seme DistrictZF Mgcawu DistrictPlease select the district you are located in?North West District *Please select an optionBojanala Platinum DistrictDr Kenneth Kaunda DistrictDr Ruth Segomotsi Mompati DistrictNgaka Modiri Molema DistrictPlease select the district you are located in?Western Cape District *Please select an optionCity of Cape Town MetropolitanCape Winelands DistrictCentral Karoo DistrictGarden Route DistrictOverberg DistrictWest Coast DistrictPlease select the district you are located in?Guardian / Parent Information *Please select an optionOver 18Guardian / ParentIf the Member (as above) is younger than 18, contact details of PARENT / GUARDIANNameLandlineCell PhoneEmail AddressConsent *I, the undersigned, hereby apply for registration as a Member of Federation of Dance Sport SA for the year 2024. By signing this form, I agree to abide by the rules and regulations of Federation Dance Sport SA.Important InformationNote: It is the responsibility of the Member, at all times, to ensure that Federation of Dance Sport-FS PAB is informed (in writing) of any changes in contact details pertaining to the member registration (including partnerships!), without delay.Banking DetailsRegistration fees for the year 2024 must be paid to: Bank Name: First National Bank AccountAccount Name: Federation of Dance Sport South AfricaAccount Type: ChequeAccount Number: 5022 0116 864Branch Code: 201409Reference: Name & SurnameEmail RegistrationSubmit registration form WITH proof of deposit and documentation to the Federation of Dance Sport SA e-mail: to secretariat@danceinsportsa.co.za Membership Certificates will not be issued against an Application for Registration received without proof of deposit AND required supporting documentation!Total AmountTotal AmountTotal AmountTotal AmountSubmit Registration DANCEINSPORTSA
