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Club Member
Club Administration

Coleambally Equine Centre

Member Registration

Member
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Membership Category*

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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.

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Residential Address

Address

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Post Code

Home Phone

Mobile* Please enter mobile.

Mailing Address

Address

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Work Phone Ext.

Fax No.

Other information

Rider FEI

Rider EA

Occupation

Financial:

What areas are you willing to help with?

Please enter a valid date

Running canteen

Please enter a valid date

Yes

Organising judges

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Yes

Organising training clinics

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Yes

Jump and grounds maintenance

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Yes

Fundraising

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Yes

Sponsorship

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Yes

Promotion

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Yes

Organising events/competitions (general organisation leading up to an event )

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Yes

Running events (general organisation/help during an event/clinic/comp)

Please enter a valid date

Yes

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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