Gladstone Horse Performance Club

Member Registration

Member Details

Residential Address

Mailing Address


Other information

I give consent for my name, address, gender and category of membership to be provided to the HSAA Association of Queensland and am aware that my name will be given to the insurance broker. *
Do you have or have ever suffered from any illness which might affect your activities whilst at the club eg, Epilepsy, Asthma, Diabetes etc *
If yes, please provide details
Name of Preferred Vet *
Vet's phone number *

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?

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