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Club Member
Club Administration

Somersby Equestrian Club

Member Registration

Member
Family
Emergency Contact
Other Info.
Merchandise
Fees
Terms / Conditions
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Membership Category*

Please select membership category.

Member Details

Title

First Name* Please enter first name.

Last Name* Please enter last name.

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

Country

State

Post Code

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 Ext.

Fax No.

Other information

Rider FEI

Rider EA

Occupation

Financial:

If you are under 18, please advise your Parent/Guardians name and contact details (if not under 18, please put NA) *

Please enter a valid date Required field is missing.

I understand that it is a condition of membership that I contribute at least one day per year of voluntary work for the Club *

Please enter a valid date Required field is missing.

Yes I would love to help out with:

Please enter a valid date

Gear Check *

Please enter a valid date

Yes

Required field is missing.

Pencilling *

Please enter a valid date

Yes

Required field is missing.

Scoring *

Please enter a valid date

Yes

Required field is missing.

Running/General Duties *

Please enter a valid date

Yes

Required field is missing.

Horse 1 Name

Please enter a valid date

Horse 1 Bridle Number

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Horse 1 EA Number (owner/rider)

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Horse 1 EA Number

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Horse 2 Name

Please enter a valid date

Horse 2 Bridle Number

Please enter a valid date

Horse 2 EA Number

Please enter a valid date

Horse 3 Name

Please enter a valid date

Horse 3 Bridle Number

Please enter a valid date

Horse 3 EA Number

Please enter a valid date

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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