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Club Member
Club Administration

NorthHarbourDistrict-Kaukapakapa

Member Registration

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Membership Category*

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Member Details

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

Email* Please enter email. Invalid email.

Alternate Email1 Invalid Email.

Residential Address

Address* Please enter address.

Suburb* Please enter suburb.

Country

Mobile* Please enter mobile.

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

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Do you coach at Pony Club? *

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Yes

Required field is missing.

If Yes at What Level

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Do you have a First Aid Certificate *

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Yes

Required field is missing.

If Yes, 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

Do not wish to answer

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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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