Gauteng Inter-Region @ UJ – Electronic Indemnity & Code of Conduct Agreement Electronic Indeminity & Code of Conduct Signature Participant's Category Participant's role in this tournament * Tournament PlayerArbiterTeam ManagerTeam Coach Is Participant a Minor? * Yes No Participant's Details Name * Name Full Name(s) Full Name(s) Surname Surname Date of Birth * South African ID / Passport no * Participant's South African ID / Passport no Chess SA ID no * Not sure how to find your Chess SA ID? Please follow this link with detailed instructions.If you do not have a Chess SA ID yet, please enter the number "0". Email * Phone * Chess Region * Johannesburg Metro ChessTshwane ChessEkurhuleni Chess AssociationSedibeng ChessDr Kenneth Kaunda ChessWest Rand Chess Parent / Legal Guardian / Supervisor of Player Name * Name Full Name(s) Full Name(s) Surname Surname Email * Phone * Medical Aid Medical Aid Fund Plan Main Member of Fund Medical Aid Number Emergency contact number * Particulars of any illness/ weakness of any kind regarding player / official that the LOC should be aware of. Indicate any medicine requirements If you are human, leave this field blank. Next