January - December 2023  
     
  Membership Type
 
     
  Adult 1    
  Surname  
  Given Names  
  EWA Number  
  Adult 2    
  Surname  
  Given Names  
  EWA Number  
  Child 1    
  Surname  
  Given Names  
  EWA Number  
  Date of Birth  
  Child 2     
  Surname  
  Given Names  
  EWA Number  
  Date of Birth  
  Child 3    
  Surname  
  Given Names  
  EWA Number  
  Date of Birth  
  Child 4    
  Surname  
  Given Names  
  EWA Number  
  Date of Birth  
       
  Contact Details    
  Address 1  
  Address 2  
  Suburb  
  Postcode  
  Mobile Phone  
  Email  
     
     
I hereby agree to abide by the Constitution, Policies and the Rules and Regulations 
of the Southern Districts Dressage Club Inc, and I am aware these are available on  
the Club's website (Refer www.sddc.org.au)
I acknowledge that my membership information will be provided to the Albany 
Equestrian Centre Association in accordance with the Club's Privacy Policy
 (a full copy of which is available on the Club's website) as part of my 
automatic membership with that Association.
  Fees Due:    
   
  Membership Discount  
  Total Fees Due  
  Your Membership will not be accepted without payment of the above fee  
       
Direct Transfer
Account Name Southern Districts Dressage Club
BSB 036-168
Account Number 15-8842
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 Southern Districts   
  Dressage Club, 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)