Add C-Pass Subscriber

C-Pass Subscriber Registration

Step 1 of 7 - Personal Details

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Time Stamp

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Associated Company

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Associated Company ID

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Application Status

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Submission Date

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Onboarding Role

DO not change this . Functionality vital to User Registration Feed

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Current Users Role

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C-Pass Already Allocated

Card Number

Reference Number

Name(Required)

Date of Birth(Required)

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Age

ID / Passport Number(Required)

Cell Phone(Required)

Email(Required)

You MUST have your own email address to be able to register on this system. You can get a free email address at GET A FREE GMAIL ADDRESS

City of Residence(Required)

Gender(Required)

Male

Female

Prefer not to say

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Vaccination Status

Fully Vaccinated

Medically unable to vaccinate

Prefer not to say

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Date of last vaccination?

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Photo of your Vaccination Certificate

Please take a picture of your Vaccination Certificate

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, heic, Max. file size: 10 MB, Max. files: 2.

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Health & Safety Induction(Required)

C-Pass Health & Safety Induction

Workplace Safety Guidelines:

The event has on-site health and safety policies & procedures including event safety guidelines, based on the Occupational Health and Safety (OHSA), its codes, regulations and practices. These policies are for your protection, and to alert you of unnecessary risks.

It is your responsibility to ensure that you seek clarification about, understand and follow these safety procedures, specific company safety regulations, signs and legal requirements that may apply to your job.

Whilst on any site administered by the C-Pass system and by virtue of my consent to this induction form below, I agree to adhere to and/or implement the following safe work practices:

Comply with all relevant laws relating to workplace health and safety and environment protection;
Co-operate in ensuring a safe and healthy work environment and take all reasonable measures to ensure the health and safety of others in the work place, including being responsible for protecting my own health and safety;
Obey all reasonable directions from the management team and their agents;
If responsible for other employees, I will make sure they are effectively supervised and instructed in safe systems of work, work practices and the nature of any hazards associated with work tasks;
Ensure that I hold relevant all certificates of competency, medical certificate, licenses or permits are in place before undertaking work requiring such qualifications;
Ensure that I possess relevant competence and experience before undertaking work activities;
Wear appropriate personal protective equipment (PPE) as may be necessary to ensure health and safety on site.
Report potential and actual health and safety hazards as soon as possible to the Health and Safety Representative, or to my immediate supervisor.
Report any incidents or “near miss” incidents to the Health and Safety Representative and / or my immediate supervisor before the end of any working shift.
Ensure the safe use of any ladder – which will be inspected and in good working order;
Not to undertake any Hot Work within on site, nor in open spaces where combustible materials may be present. Ensure no hot work is to undertaken without precautions in place against the initiation and spread or fire;
Ensure all portable electrical equipment plugs and leads have been inspected and are in good condition.
Allow only authorised persons holding an appropriate valid current license to operate any vehicles on the premises.
Refrain from smoking tobacco inside any premises.
Not to consume and will ensure prohibition on consumption of drugs or alcohol on premises or sites for persons conducting work is maintained
Keep working areas clean and tidy from waste paper, general refuse and other hazards. All waste must be cleaned up promptly and disposed of – or recycled in a responsible manner.
I will perform all work operations at a safe working speed.
I will report any injury, no matter how minor, before the end of any working shift, to the Safety Officer or to my immediate supervisor.
I am aware that no flammable liquids or hazardous chemical substances are permitted on premises.
I am aware that no private electrical appliances may be brought onto the premises without permission

Workplace Hazards:

I am aware of the event industry OHS hazards and site specific safety hazards and I am aware that the premises requires me to implement safe work processes while working on the site in taking mitigating steps against any risks becoming a reality.

Site Safety Induction:

I understand the above site induction rules and understand they are in place to keep me safe. I agree to take safety seriously while working on the site.

I agree and understand the contents of the health & safety induction

You are required to scroll to the end of this induction and consent

Consent(Required)

I hereby consent

C-Pass Health & Safety Induction

Workplace Safety Guidelines:

Whilst on any site administered by the C-Pass system and by virtue of my consent to this induction form below, I agree to adhere to and/or implement the following safe work practices:

Comply with all relevant laws relating to workplace health and safety and environment protection;

Co-operate in ensuring a safe and healthy work environment and take all reasonable measures to ensure the health and safety of others in the work place, including being responsible for protecting my own health and safety;

Obey all reasonable directions from the management team and their agents;

If responsible for other employees, I will make sure they are effectively supervised and instructed in safe systems of work, work practices and the nature of any hazards associated with work tasks;

Ensure that I hold relevant all certificates of competency, medical certificate, licenses or permits are in place before undertaking work requiring such qualifications;

Ensure that I possess relevant competence and experience before undertaking work activities;

Wear appropriate personal protective equipment (PPE) as may be necessary to ensure health and safety on site.

Report potential and actual health and safety hazards as soon as possible to the Health and Safety Representative, or to my immediate supervisor.

Report any incidents or “near miss” incidents to the Health and Safety Representative and / or my immediate supervisor before the end of any working shift.

Ensure the safe use of any ladder – which will be inspected and in good working order;

Not to undertake any Hot Work within on site, nor in open spaces where combustible materials may be present. Ensure no hot work is to undertaken without precautions in place against the initiation and spread or fire;

Ensure all portable electrical equipment plugs and leads have been inspected and are in good condition.

Allow only authorised persons holding an appropriate valid current license to operate any vehicles on the premises.

Refrain from smoking tobacco inside any premises.

Not to consume and will ensure prohibition on consumption of drugs or alcohol on premises or sites for persons conducting work is maintained

Keep working areas clean and tidy from waste paper, general refuse and other hazards. All waste must be cleaned up promptly and disposed of – or recycled in a responsible manner.

I will perform all work operations at a safe working speed.

I will report any injury, no matter how minor, before the end of any working shift, to the Safety Officer or to my immediate supervisor.

I am aware that no flammable liquids or hazardous chemical substances are permitted on premises.

I am aware that no private electrical appliances may be brought onto the premises without permission

Workplace Hazards:

Site Safety Induction:

I understand the above site induction rules and understand they are in place to keep me safe. I agree to take safety seriously while working on the site.

I hereby consent to the following :

a. We may use the contact details provided by you to contact you relating to C-Pass activities. This may include SMS and/or email communication.
b. To the storing of my data for and on behalf of "Organisors" as part of their compliance with the Occupational Health and Safety Act no 85 of 1993, National Health Act 61 of 2003, Safety at Sports and Recreational Events Act 2 of 2010 and all it's current and subsequent regulations as are amended from time to time.

I understand that I can request my data to be deleted at anytime by sending an email to deletion@c-pass.co.za but should I request this deletion my access to c-pass.co.za and my access pass itself will become null & void and any cards purchased must be surrendered on request.

Signature(Required)

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User

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Group Allocation

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Categorisation Tag