COVID-19 Indemnity

 

COVID-19 Indemnity

  • WESTERN PROVINCE SQUASH
    Villager Squash Complex, 11 Imam Horan Road, Claremont 7708
    Telephone: (021) 674 6717
    email: administrator@wpsquash.co.za
  • A PDF version of this form will be sent to you and to Durbanville Squash Club after submission.
  • Please enter your full name(s) and surname as it appears on your ID Card / Book.
  • Please enter your South African ID number or Passport Number
  • Please enter your primary phone number / mobile number
  • Please enter the email address you would like us to send your copy of the form to
  • I hereby indemnify Durbanville Squash Club , Western Province Squash Federation and Squash South Africa against any claim whatsoever arising from me contracting COVID 19 while playing squash at Durbanville Squash Club.
  • Note: Submission of this form will include your IP Address and your web browser user agent details, which will be used in the event of any dispute in the validity of your submission. The form may take a few seconds to submit while the PDF is created so please do not close your browser until you are redirected to the thank you page.