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APPLICATION FOR MEMBERSHIP
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1 February 2019 to 31 January 2020
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Membership Type
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Member's Name
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Surname
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Given Names
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Date of Birth(if under 18)
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Guardian Name (if Member
under 18 years)
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Surname
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Given Names
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Family Membership
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(limited to a maximum of 4 family members, including
above member, and may
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be 2 adults and 2 children (under 18 years) or 1
adult and 3 children (under 18 years),
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all residing at the same address).
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Other Family Members (included in this membership)
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Surname
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Given Names
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Date of Birth(if under 18)
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Surname
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Given Names
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Date of Birth(if under 18)
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Surname
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Given Names
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Date of Birth(if under 18)
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Contact Details
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Address 1
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Address 2
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Suburb
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Postcode
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Mobile Phone
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Home Phone
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Work Phone
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Email
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If you are a member of Equestrian
Australia or Showhorse Council of WA,
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please provide your membership
number.
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Equestrian Australia
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Showhorse Council of WA
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I hereby agree to abide by the Constitution,
Policies and the Rules and Regulations
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of the Albany Horseman's Association.
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I acknowledge that my membership information will be
provided to the Albany
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Equestrian Centre Association in accordance with the
Club's Privacy Policy
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as part of my
automatic membership with that Association, which enables use of the
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Albany Equestrian Centre grounds outside of
competition.
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Fees Due:
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Total Fees Due
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Your Membership will not be accepted without
payment of the above fee
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Payment Method
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Direct Transfer
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Account Name
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Albany Horseman's Association
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BSB
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066-500
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Account Number
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0080-0052
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Horse Sports are a Dangerous Activity
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I understand and acknowledge that horse sports are a
dangerous activity and
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that horses can act in a sudden and unpredictable
way, especially if
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frightened or
hurt.
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I understand and acknowledge that serious INJURY or
DEATH may result from
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horse
sport activities and in
particular from events in which I participate.
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I agree that I PARTICIPATE at my OWN RISK.
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Effect of this Document
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I understand that submission of this Application for
Membership constitutes
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a complete
and unconditional release of the
Equestrian Federation of
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Australia Ltd including all of its state bodies,
coaches and Albany Horseman's
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Association, to the greatest extent allowed by
law in the event of me and/or
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the children under my care, suffering injury or
death.
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HELMETS: From 1st January, 2017, you
are required to wear a helmet that complies with
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Equestrian
Australia’s updated standards. Albany Horsemen’s Association is
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affiliated with Equestrian Australia. By submitting this form is my
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acknowledgement of these compliance
requirements.
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By submitting this Membership application, I ACCEPT I confirm having
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read and understood the contents of this disclaimer.
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