Membership 2017 – Individual Signup

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ID Number / Date of birth

Emergency Contact name and number

Medical Aid name and number

I would like to pick up my card at the following outlet

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Farm Windhoek, Bank Windhoek, Maerua Mall, 483-872, Acc no 8004143016, Cheque
(Please use your name and surname as reference)

ATTENTION
Due to the nature of activities such as, but not limited to; hiking, mountain biking, dog walking, and bird watching in the picturesque but potentially dangerous terrain; by entering Commonage 2, you hereby unconditionally and irrevocably indemnify and exempt Commonage 2, its owners, staff, holding company, subsidiaries, directors, shareholders, employees or agents from any liability as to any claim, action, damages, inconvenience, loss, fatality, illness or injury to person or property of whatever nature, arising from your use of this property and/or presence within Commonage 2.
YOU HEREBY AGREE TO USE THIS PREMISES/LOCATION ENTIRELY AT YOUR OWN RISK AND TO ABIDE BY THE ‘RULES’OF THE FARM.

I accept the above terms and conditions