AHAMembershipForm2019











	APPLICATION FOR MEMBERSHIP
	1 February 2019 to 31 January 2020

	Membership Type

	Member's Name
	Surname
	Given Names
	Date of Birth(if under 18)
	Guardian Name (if Member under 18 years)
	Surname
	Given Names
	Family Membership
	(limited to a maximum of 4 family members, including above member, and may
	be 2 adults and 2 children (under 18 years) or 1 adult and 3 children (under 18 years),
	all residing at the same address).
	Other Family Members (included in this membership)
	Surname
	Given Names
	Date of Birth(if under 18)

	Surname
	Given Names
	Date of Birth(if under 18)

	Surname
	Given Names
	Date of Birth(if under 18)

	Contact Details
	Address 1
	Address 2
	Suburb
	Postcode
	Mobile Phone
	Home Phone
	Work Phone
	Email

	If you are a member of Equestrian Australia or Showhorse Council of WA,
	please provide your membership number.
	Equestrian Australia
	Showhorse Council of WA

	I hereby agree to abide by the Constitution, Policies and the Rules and Regulations
	of the Albany Horseman's Association.

	I acknowledge that my membership information will be provided to the Albany
	Equestrian Centre Association in accordance with the Club's Privacy Policy
	as part of my automatic membership with that Association, which enables use of the
	Albany Equestrian Centre grounds outside of competition.

	Fees Due:


	Total Fees Due

	Your Membership will not be accepted without payment of the above fee

	Payment Method

	Direct Transfer
	Account Name	Albany Horseman's Association
	BSB	066-500
	Account Number	0080-0052


	Horse Sports are a Dangerous Activity
	I understand and acknowledge that horse sports are a dangerous activity and
	that horses can act in a sudden and unpredictable way, especially if
	frightened or hurt.
	I understand and acknowledge that serious INJURY or DEATH may result from
	horse sport activities and in particular from events in which I participate.
	I agree that I PARTICIPATE at my OWN RISK.
	Effect of this Document
	I understand that submission of this Application for Membership constitutes
	a complete and unconditional release of the Equestrian Federation of
	Australia Ltd including all of its state bodies, coaches and Albany Horseman's
	Association, to the greatest extent allowed by law in the event of me and/or
	the children under my care, suffering injury or death.
	HELMETS: From 1^st January, 2017, you are required to wear a helmet that complies with
	Equestrian Australia’s updated standards. Albany Horsemen’s Association is
	affiliated with Equestrian Australia. By submitting this form is my
	acknowledgement of these compliance requirements.
	By submitting this Membership application, I ACCEPT I confirm having
	read and understood the contents of this disclaimer.