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Club Member
Club Administration

ThamesValley-Thames

Member Registration

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Membership Category*

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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

Email* Please enter email. Invalid email.

Alternate Email1 Invalid Email.

Alternate Email2 Invalid Email.

Residential Address

Address

Suburb

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Home Phone

Mobile* Please enter mobile.

Mailing Address

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Work Phone Ext.

Other information

Rider FEI

Rider EA

Occupation

Financial:

Are you a Certificate Examiner

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Yes

If Yes at what Level?

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Have you read the Thames Branch Pony Club Membership Forms?

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Yes

Have you read the Thames Branch Pony Club H&S Register 2020?

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Yes

Do you coach at Pony Club?

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Yes

If Yes at What Level

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Ethnicity - Choose from the following options

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NZ European

Maori

Pacific Peoples

Asian

Middle Eastern/Latin America/Africa

Other

NZ Maori European

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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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