Please print this form post or fax it to the address below


                              Domain:____________________            Date:________________



Organisation Name:

(The Applicant)








Postal Address:


Complete Domain Name:



IP Number to point domain to: (if you have one)

Additional DNS entries:  (e.g.


Detail of Administrative Contact:        






Name:                                                                                     Surname:                                    




Title/Position:                                                                          Organization:



Phone Number:                                              Fax:                                              Email Address:



Postal Address:



The Applicant named above hereby authorizes Agora international cc as its agent to apply for registration of the Internet domain specified above and to manage name resolution for the domain on Agora’s DNS servers.


The Applicant warrants that it has read and that it accepts Agora international cc’s Terms and Conditions for Internet Domain Registration.  The person signing on behalf of the Applicant organisation warrants that he/she has the required authority to bind the organisation to these terms and conditions.



Signed at .........…………………........................ this ...……. day of      ................. 19....




Signature…………………........Name (block capitals) ..……………………………………....................





Terms and Conditions for Internet Domain Registration.


Agora International cc (Agora) acts as agent in applying for and maintaining Internet Domain Registrations.  The person or organisation which requests Agora to setup an Internet Domain (the Applicant) is the principle in the relationship with the relevant registering authority and authorises Agora to act on it’s behalf in this regard.


1)       The Applicant represents, warrants and agrees as follows...

(a)     that the Applicant's statements in the application are true and that the applicant has the right to use the Domain Name as requested in the Application;

(b)     The use or registration of the Domain Name by Applicant does not interfere with nor infringe the right of any third party in any jurisdiction with respect to trademark, service mark, tradename, company name, close corporation name, copyright nor any other intellectual property right;

(c)     Applicant is not seeking to use the Domain Name for any unlawful purpose, including, without limitation, delictual interference with contract or prospective business advantage, unfair competition, injuring the reputation of another, nor for the purpose of confusing or misleading a person, whether natural or incorporated.

(d)     To be bound by the standard terms and conditions of the relevant registering authority as published and amended from time to time.

(e)     to pay any fee’s demanded by the relevant registering authority from time to time.


2)       The Applicant is responsible for its selection of the Domain Name. Consequently, the Applicant shall defend, indemnify and hold harmless Agora international cc, its officers, employees and agents, for any loss, damage, expense or liability resulting from any claim, action or demand arising out of or related to the use or registration of the Domain Name, including reasonable attorneys fees.  Such claims shall include, without limitation, those based upon tradename infringement, copyright infringement, dilution, delictual interference with contract or prospective business advantage, unfair competition, defamation or injury to business reputation.  Agora agrees to give Applicant written notice of any such claim, action or demand within a reasonable time.  Applicant agrees that Agora international cc shall be defended by attorneys of Agora international cc's choice at Applicant's expense, and that Applicant shall advance the costs of such litigation, in a reasonable fashion, from time to time.


3)       Agora international cc will create or amend any additional DNS entries requested on the application or within 14 day’s of the application free of charge.   Any additions or amendments after that time will incur a charge.  Agora will charge an initial setup fee and a yearly maintenance fee.  Agora’s charges are specified in Agora’s price list as amended from time to time.


4)       Where additions, amendments or renewals require a change to the information lodged with the relevant registering authority, the registering authority may levy a fee which will be for the account of the applicant.


5)       Agora international cc will not be liable for any loss of use, interruption of business, or any indirect, special, incidental, or consequential damages of any kind (including lost profits), regardless of the form of action, whether in contract, delict, or otherwise, even if Agora international cc has been advised of the possibility of such damages.  In particular Agora will not be liable should the registering authority refuse or fail to register or maintain the registration of the domain for any reason.


6)       The Applicant consents to the jurisdiction of any competent South African Magistrate's court for the adjudication of any legal dispute between Agora international cc. and the Applicant and these terms and conditions will be construed and interpreted in accordance with the law of the Republic of South Africa.


7)       The Applicant acknowledges that the terms and conditions hereof may not be varied or cancelled except in writing and signed by Agora international cc and the Applicant.


8)       In the event that any of the terms of this contract are found to be invalid, unlawful or unenforceable, such terms will be severable from the remaining terms, which will continue to be valid and enforceable.



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