Clubs

Hobart & Districts Pony Club

Member Registration

Member
Family
Emergency Contact
Other Info.
Merchandise
Fees
Terms / Conditions
Process Payment

Membership Category:*

Member Details

Title:

First Name:*

Last Name:*

Date Of Birth:*

Sex:*

Email:*

Alternate Email1:

Residential Address

Address:

Suburb:

Country:

State:

Post Code:

Mobile:*

Other information

PCT Member Number:*	Please enter a valid date Required field is missing
Parent/Guardian Details:	Please enter a valid date
Parent/Guardian Name:*	Please enter a valid date Required field is missing
Phone Number:*	Please enter a valid date Required field is missing
If the rider is allergic to anything please provide details and action plan:*	Please enter a valid date Required field is missing
Does the rider have any other medical conditions, if so please provide details:*	Please enter a valid date Required field is missing
Club Assistance:	Please enter a valid date
There will be times when we will be asking for your assistance for working bees ,stewards at comps , fund raisers for club:*	Please enter a valid date Required field is missing