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Club Member
Club Administration

TaupoDistrict-Oruanui

Member Registration

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Membership Category:*

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Member Details

Title:

First Name:* Please enter first name

Last Name:* Please enter last name

Date Of Birth:* Please select date of birth Please enter a valid date

Sex:

Email:* Please enter email Invalid email

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Alternate Email2: Invalid Email

Residential Address

Address:

Suburb:

Country:

State:

Post Code:

Home Phone:

Mobile:* Please enter mobile

Mailing Address

Address:* Please enter address

Suburb:

Country:

State:

Post Code:* Please enter post code

Other information

Rider FEI:

Rider EA:

Occupation:

Financial:

Are you a Certificate Instructor:*

Please enter a valid date

Yes

Required field is missing

If Yes at What Level:

Please enter a valid date

Do you coach at Pony Club?:*

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Yes

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If Yes at What Level:

Please enter a valid date

Ethnicity - Choose from the following options:*

Please enter a valid date

Asian

Do not wish to answer

Maori

Middle Eastern/Latin America/Africa

NZ European

NZ Maori European

Other

Pacific Peoples

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Email address is already assigned to a member,
please use an alternative email address.

You appear to be an existing member.
Do you want to renew your membership?

Primary member must be over 18 years of age.

Aged pension membership is for members over 65 years.
Please choose another membership type or correct your date of birth.

EA number does not match member name.

To be eligible for this membership, a doctors certificate/para classification/RDA associate membership must be provided to the club to receive a code to apply for this membership type. Please type code in below.

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