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Regular Member Registration form

Regular Members Full Information

First Name

Middle Name

Last Name

Sex

Age

Phone

Email Address

ADRESS

Sub-city

Worada

House Number

CHILDREN OR LEGALY ADAPTED CHILDREN INFORMATION

CHILDREN OR LEGALLY ADAPTED CHILDREN INFORMATION *

Middle Name

Last Name

Age

Date Of Birth

Sex

Place Of Birth

Mother's Full Name

Father's Full Name

LEGAL GUARDIAN INFORMATION (If Any Has)

NAME OF MEMBER'S PARENT OR GUARDIAN RESPONSIBLE TO COMMUNICATE WITH THE ASSOCIATION

Middle Name

Last Name

Worada

House Number

RELATION SHIP WITH THE CHILD *

Name Of Member's Parent Or Guardian Responsible To Communicate With the Association

Name

Phone

VERIFICATION SIGNATURE

I/We acknowledge having read the guidelines and membership terms and conditions and agree to follow the association's rules and regulations.We also guarantee that the information we provide is accurate and truthfull.

Name

upload signatureupload image that has your signature

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Photographs of the regular member.Upload file

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Birth certificate.

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Medical diagnosis and clinical testing report from a government or private healthcare institution confirming the member’s condition.

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If the responsible party is a [parent (mother or father)], provide parent’s ID

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[parent (mother or father)] photograph

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If the responsible party is a [legal guardian], provide a certified legal guardianship document.

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[legal guardian] ID

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[legal guardian] photograph

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Registration fees: Individuals - Membership: 200, Registration: 100r (Total 300 Birr). Please upload a screenshot of the payment confirmation.

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Regular Member Registration form

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