Huntingfield Pony & Riding Club Inc

Member Registration

Member Details

Residential Address

Mailing Address

Ext:

Other information

Please advise your membership category:*
PCT Member Number:*
Parent/Guardian details (not required for Adult Riding Members)):
Parent/Guardian No 1 Name:
Parent/Guardian No 1 Address:
Parent/Guardian No 1 Mobile:
Parent/Guardian No 1 Email:
Parent/Guardian No 2 Name:
Parent/Guardian No 2 Address:
Parent/Guardian No 2 Mobile:
Parent/Guardian No 2 Email:
Horse/Riding Details (not required for Adult Riding Members):
Name of Horse/Pony:
Age:
Height:
Colour:
How long owned by you?:
Does your horse have previous pony club experience? Pleaes provide details:
Riding Experience::
Please provide information on previous riding experience, ie have you had regular lessons and if so, with whom? Have you been a member of any other Pony Club or Riding Club?:
As you are aware, the success of any club depends heavily on the support and involvement of our members and community.:
There will be times when we will be asking for your assistance. Please indicate below which areas you would prefer to be contact about, to help your club:
Canteen:
Working bees/grounds:
Events/fundraisers:
Committee membership:
Newsletter:
Other:
Health Statement:
Main contact person at pony club events:*
Phone Number:*
Other Emergency Contact No 1 Name:*
Other emergency contact No 1 phone number:*
Other Emergency Contact No 2 Name:
Other emergency contact No 2 phone number:
Normal Doctor Name:*
Normal Doctor Address:*
Normal Doctor Phone Number:*
When was the rider's last tetanus injection given?:*
Does the rider suffer from asthma?:*
If yes, please send asthma plan prepared by doctor to club:
Is the rider allergic to any drugs?:*
If yes, please give details and action plan:
Does the rider have any allergies other than drugs?:*
If yes, please give details and action plan (ie jack jumpers, peanuts):
Does the rider have any other medical problems?:*
If yes, please provide details:
Membership Information

 

 

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

You appear to be an existing member.
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Aged pension membership is for members over 65 years.
Please choose another membership type or correct your date of birth.