Coffs Coast Jump Club Inc.

Member Registration

Member Details

Residential Address

Mailing Address

Ext:

Other information

Are you a non-riding social member?:*
Are you a junior rider under 18?:*
If yes please state your Date of Birth:
Are you a member of Equestrian Australia? :*
If no, do you have Ambulance Cover?:
Do you object to having your image used on social media or in other media to promote the club?:*
Do you object to us providing your email address to our major sponsors so they can advise you of special offers and promotions?:*
Please indicate height you are training? :
Please indicate height you are competing?:
What are your goals for the coming year?:
How did you hear about us?:*

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.