Mersey Valley Pony Club

Member Registration

Member Details

Residential Address

Mailing Address


Other information

Previous Membership if any:
Riders Age
Horse Details
Horse Name:
Horse Name:
Horse agisted at: (if not at home address)
It is PCAT Policy for all non-riding adults who regularly attend Pony Club to have a Working With Children Check (WWC) *
If you have a WWC, please provide the number and expiry date
PCAT Certificates:
Please advise here if you do NOT want photos of yourself/rider/other family member publicised.
Any skiills or other attributes that might be useful to the club?

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.