CSIR Sports and Recreation Facility: Membership Application Form

CSIR Sports Club 

Membership Application Form

Please complete all sections and return via email to csirclub@csir.co.za. The contents of this form will remain confidential and will only be used as stated in the Privacy Statement below, in compliance with PoPIA (Act 4 of 2013).

Apply using the form below
Asterisk (*) indicates a required field.

Membership Application Form

1. Sub-club Selection

Select all the sub-clubs you intend to join. You may choose more than one.

Club Selection

2. Contact Details

Your personal contact information.

Member Type
Medical Aid

3. Emergency Contact Information

Next of kin — this person will only be contacted in the event of an emergency.

4. Waiver and Assumption of Risk

Please read each section carefully and check the box to confirm your agreement.

Use of Facilities Indemnity

On behalf of myself and/or my dependents/executor, I hereby acknowledge and declare that I am entering the CSIR Recreational Site situated on the premises of the CSIR, Meiring Naude Road, Brummeria, Pretoria, at my own risk and on the express condition that neither the CSIR, nor any of its officers/employees, shall be liable to me or my dependents/executor for any damages arising out of loss of life or bodily injuries suffered by me, or for any loss of or damage to my property or estate, arising out of any accident or cause which may occur during my visit to the premises, whether or not such accident or cause arises out of negligence, failure, incompetence or any other act whatsoever, on the part of the CSIR or any of its officers/employees; and on behalf of myself, my executor and dependents. I do hereby indemnify, hold harmless and absolve the CSIR, its officers and employees against any damage whatsoever and legal expenses or costs which may arise out of my stay at/visit to the premises.

Sports and Recreation Club Affiliation – Release and Indemnification

I understand and acknowledge that participating in activities run by the CSIR Sports and Recreation Club and sub-clubs carries a certain risk of physical injury, which may occur through no fault of any volunteer, participant, employee, or coach affiliated with the club.

I fully understand that the programme may be strenuous physically and mentally and choose to participate completely voluntarily. I accept full responsibility for my own safety. I agree not to hold the instructors or management responsible for any injuries which may occur.

Furthermore, I realise that it is my responsibility to know my own limits and will not act in a manner that will bring harm to myself or others. It is also my duty to immediately point out any injuries or limitations that I may have to the instructors/coaches or management and to seek medical attention. I agree that I will not continue with any session if prohibited to by the coach/instructor. It is also my duty to report any safety issues/concerns to the CSIR Sports and Recreation Club / Club Executive, or any appointed authority.

I fully understand and agree to all of the above. I also agree to comply with and respect all safety rules and notices presented by the club instructors / coaches and/or management. The clubs hold the right to terminate any contract or membership at any time for affiliated members who fail to comply with the aforementioned or Club Constitution.

This Waiver and Release of Liability shall remain valid for the entire period of my club membership and participation in its activities and will remain in force until it is expressly revoked by written notice from me to the clubs; provided, however, that any such revocation shall not in any manner affect the waiver, release of liability, and indemnification given for any acts or occurrences prior to such receipt of said written notice to the clubs or prior to termination of my participation.

Disclaimer

5. Signature

If the applicant is under 18, a parent or guardian must also sign.

✍️   Print and sign, or attach an electronic signature
✍️   Parent or guardian signature — if applicable

6. Privacy Statement

In accordance with the Protection of Personal Information Act, 2013 (PoPIA, Act 4 of 2013). This privacy statement will inform you what the CSIR or the CSIR Sports Club will do with the personal information it collects from you. It also indicates your rights as a data subject.

  • This privacy statement will apply to the CSIR or the CSIR Sports Club and the personal information supplied by you. It includes any processing or further processing of the personal information by any operators duly appointed by the CSIR or the CSIR Sports Club.
  • The CSIR or the CSIR Sports Club will require explicit consent from data subjects to participate in sports and recreation activities. Until such consent is provided, the CSIR or CSIR Sports Club will not have access to the personal information of the data subject.
  • To determine the membership numbers, identities, and other statistical information of the CSIR Sports Club’s legitimate members;
  • To give or allow controlled access to the CSIR premises and to the CSIR Sports Club facilities for security purposes;
  • To allow for participation in all administrative and sporting activities of the CSIR Sports and Recreation Club;
  • To determine the type of and extent to which the CSIR or the CSIR Sports Club needs to cater for the related needs of the members and other users of the sports and recreation facilities;
  • To have in the possession of the CSIR or the CSIR Sports Club relevant personal information necessary for the CSIR or the CSIR Sports and Recreation Club to respond appropriately in cases of emergency of whatever sort; and
  • To perform internal operations, including administrative duties like maintaining, storing and reporting on the requests received to any regulatory bodies and internally to management.
  • Your personal information will be stored either physically in record storerooms or electronically in a centralised database, which, for operational reasons, will be accessible on a need-to-know and business basis.
  • The CSIR or the CSIR Sports Club undertakes to conduct regular audits regarding the safety and security of your personal information.
  • Once the personal information is no longer required because the purpose for which it was held has expired, your personal information will be safely and securely archived for the requisite and prescribed retention periods as required by law. On expiration of this retention period, the CSIR will permanently destroy your personal information or send it to approved external storage facilities that are PoPIA compliant, as the case may be.
  • The CSIR may have to disclose your personal information to other parties, including other sporting organisations or federations, sponsors, auditors, regulatory bodies, and/or government officials. The CSIR or the CSIR Sports Club will always ensure that there is a legitimate reason for such disclosure and that your personal information is handled with strict confidentiality and data security conditions.
  • Your personal information will not be transferred across the borders of South Africa.
  • You are encouraged to make immediate contact with the CSIR’s Privacy Office at any time if you are not comfortable or satisfied with the manner in which the CSIR or the CSIR Sports Club is processing your personal information. On receipt of your objection, the CSIR or the CSIR Sports Club will place a hold on any further processing until the cause of the objection has been resolved. If you are still not satisfied with such process, you have the right to lodge a complaint with the Information Regulator at POPIAComplaints@inforegulator.org.za .
  • PoPIA requires that all your personal information and related details, as supplied, are complete, accurate and current. It will be your responsibility to advise the CSIR or the CSIR Sports Club of any changes to the personal information, as and when these may occur.
  • You have the right at any time to ask the CSIR or the CSIR Sports Club to provide you with the details of the personal information which the CSIR or the CSIR Sports Club holds on your behalf; and/or the purpose for which it has been used, provided that such request is made using the standard section 14 CSIR PAIA process, which can be accessed by downloading and completing the standard request for information form, housed under the CSIR’s section 14 PAIA Manual, which can be found on the CSIR’s website at www.csir.co.za .

Please see fees structure and read the terms and conditions and agree