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Club Member
Club Administration

TeKauwhataDistrict-Pukekawa

Member Registration

Member
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Membership Category*

Please select membership category.

Member Details

Title* Please select title.

First Name* Please enter first name.

Last Name* Please enter last name.

Date Of Birth* Please select date of birth. Please enter a valid date

Sex* Please select sex.

Email* Please enter email. Invalid email.

Alternate Email1 Invalid Email.

Alternate Email2 Invalid Email.

Residential Address

Address* Please enter address.

Suburb* Please enter suburb.

Country

State* Please select state.

Post Code* Please enter post code.

Home Phone* Please enter home phone.

Mobile* Please enter mobile.

Mailing Address

Address* Please enter address.

Suburb* Please enter suburb.

Country

State* Please select state.

Post Code* Please enter post code.

Work Phone* Please enter work phone. Ext.

Fax No.

Other information

Rider FEI

Rider EA

Occupation

Financial:

Are you a Certificate Examiner *

Please enter a valid date

Yes

Required field is missing.

If Yes at What Level

Please enter a valid date

Do you coach at Pony Club? *

Please enter a valid date

Yes

Required field is missing.

If Yes at What Level

Please enter a valid date

Ethnicity - Choose from the following options *

Please enter a valid date

NZ European

Maori

Pacific Peoples

Asian

Middle Eastern/Latin America/Africa

Other

NZ Maori European

Do not wish to answer

Required field is missing.

Annual Fees

Annual Fees as are follows:-

Adult member/volunteer = $20

1st Riding member = $190

Additional Riding Members $135

Our fees consist of a portion going to District and Head Office. The rest of the fee covers the instruction for the year.

Pukekawa Pony Club is run by volunteers (parents). Please don't be shy about asking how you can help.

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

You appear to be an existing member.
Do you want to renew your membership?

Primary Member must be an Adult/18+. Children/under 18 memberships can be added on the next page.

Aged pension membership is for members over 65 years.
Please choose another membership type or correct your date of birth.

EA number does not match member name.

To be eligible for this membership, a doctors certificate/para classification/RDA associate membership must be provided to the club to receive a code to apply for this membership type. Please type code in below.

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