North QLD Show Jumping Club (NQSJC)

Member Registration

Member Details

Residential Address

Mailing Address


Other information

EA membership Number
PCAQ Membership Number:
Do you hold any of the following:
Blue Card
Senior First Aid Certificate
Any EA Accreditations, is so what ones
In becoming a club member I give permission for NQSJC to use images of your child on their website or Facebook page, advertising. *

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.