Perth Dressage Club

Member Registration

Member Details

Residential Address

Mailing Address

Ext:

Other information

EWA Membership #:*
(All PDC members must be an EWA current member – this is a condition of insurance):
Type of Membership:*
Current First Aid Certificate:*
Email Address (for PDC Correspondence): Please note that all correspondence is via email only. Also much information is available on the PDC Facebook page and the PDC Website.:
Email:*
Rider Experience:*
Current Horses:
Name:
Age:
Sex:
Competed:
Name:
Age:
Competed:
Medical Details:
Do you have any medical conditions:*
if yes please list below:
Do you have any allergies?:*
If yet please list below:
Have you had a Tetanus shot?:*
Date of last Tetanus Shot?:
If under 18 years:
Name of Parent/Guardian:
Address:
Postcode:
Telephone (home):
Work Phone:
Mobile:
I understand that a Parent or Guardian must be in attendance at all Training Days, and must be a member of PDC themselves (either full or non-riding).:
I also accept that if this parent/guardian has to leave one of the training days they must sign and hand in a Transfer of Responsibility Form on the day.:
I agree to above terms and conditions.:

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?

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