for the year ended 31 December 2019  
     
  Membership Type
 
     
  Member's Name    
  Surname  
  Given Names  
  Date of Birth(if under 18)  
  Parent/Guardian Name (if Member under 18 years)  
  Surname  
  Given Names  
       
  Contact Details    
  Address 1  
  Address 2  
  Suburb  
  Postcode  
  Mobile Phone  
  Home Phone  
  Work Phone    
  Email  
     
I hereby agree to abide by the Constitution, Policies and the Rules and Regulations 
of the Albany Equestrian Centre Association.
  Fees Due:    
   
  Membership Discount  
  Total Fees Due  
       
  Your Membership will not be accepted without payment of the above fee  
   December     
  Direct Transfer    
  Account Name Albany Equestrian Centre Inc  
  BSB 633-000  
  Account Number 143-217-743  
       
  Payment Receipt Details    
  Date  
  Amount  
  Receipt Number  
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 Equestrian  
  Centre Association, to the greatest extent allowed by law  in the event of me and/or   
  the children under my care, suffering injury or death.  
  By submitting this Membership application,  I ACCEPT I confirm having   
  read and understood the  contents of this disclaimer.  
   
  (Member)