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MercuryBay-Mercury Bay

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Do you have any medical conditions that may impact on your participation at Pony Club? If Yes, please list.:*

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Do you have any allergies that may impact on your participation at Pony Club? If Yes, please list.:*

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I agree to help set up before each rally and/or put away equipment at the end of each rally.:*

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Yes

No

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What are your equestrian goals for the season?:

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Do you coach at Pony Club?:*

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If Yes, at what level do you coach?:

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Ethnicity - Choose from the following options:*

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Asian

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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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