Clubs

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:

Alternate Email2:

Residential Address

Address:*

Suburb:*

Country:

State:*

Post Code:*

Home Phone:

Mobile:*

Mailing Address

Address:

Suburb:

Country:

State:

Post Code:

Work Phone: Ext:

Fax No.:

Other information

** (Please see conditions of membership for juniors in the waiver below):

I am hereby applying for Membership of the Australian Horseball Association Inc (AHBA) and agree to abide by the Rules and Regulations of the Association as well as the Code of Conduct. I am also aware that acceptance of my membership is subject to my signing of the Liability Waiver included on my membership application. :

Parent/Guardian required for Junior Membership:

Parent/Guardian name:

Parent/Guardian number:

Do you hold a First Aid Certificate?:*

Yes

If yes, please note expiry date:

Do you hold a current Blue Card:*

Yes

If yes, please note expiry date:

Australian Horse Ball Association

Member Registration

Member Details

Residential Address

Mailing Address

Other information