VC Individual 1 Year

Membership Agreement Form and Consent Form

Please fill out the following information, for your membership to be activated upon checkout. Kindly ensure you have read the Terms and Conditions of this membership, available at the bottom of this page.

Last Name / Family Name

First Name

Date of Birth

Marital Status

Single

Married

Divorced

Widowed

Mobile Phone

City of Residence

Passport Number

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I hereby acknowledge that I freely and voluntarily execute this Membership Agreement. I have read and understood the Terms and Conditions of this Membership in full, and agree to the terms therein. View Terms & Conditions

If signing on behalf of a dependent,

Representative Full Name and Relation to member

I declare that I have disclosed all particulars relevant to this application, and I warrant that I am authorized to sign on behalf of my dependent.

Member or Representative Signature

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Membership Agreement Form and Consent Form

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