Clubs

Member
Family
Emergency Contact
Other Info.
Merchandise
Fees
Terms / Conditions
Process Payment

Membership Category*

Member Details

Title

First Name*

Last Name*

Date Of Birth*

Sex

Email*

Alternate Email1

Alternate Email2

Residential Address

Address*

Suburb*

Country

State*

Post Code*

Home Phone

Mobile*

Mailing Address

Address

Suburb

Country

State

Post Code

Work Phone Ext.

Fax No.

Other information

EWA Member No. (ifapplicable)
EWA Membership Type:
Allergies: *
Pre-existing Medical Conditions: *
Riders Experience: (e.g. able to walk, trot & canter, pony club, dressage/showjumping/eventing levels competed at, western riding etc...) *
Horses Show/Racing Name: *
Horses Stable Name: *
Breed: *
Colour: *
Horse Experience: (e.g. cantering in a group, height jumping, dressage level, competition experience etc...) *
Any other information you consider relevant to place horse and rider in the appropriate groups: *

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.

Wanneroo Adult Equestrian Club

Member Registration

Member Details

Residential Address

Mailing Address

Other information