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Do you suffer from any illness or condition that KWCHC should be aware of? *	Please enter a valid date Required field is missing.
Do you suffer from a disability that KWCHC should be aware of? *	Please enter a valid date Required field is missing.
Are you allergic to any medication? *	Please enter a valid date Required field is missing.
Do you have any other allergies KWCHC should be aware of? *	Please enter a valid date Required field is missing.
Do you have any reoccuring or recent injuries KWCHC should be made aware of? *	Please enter a valid date Required field is missing.
Are you currently taking any medication prescription or otherwise? *	Please enter a valid date Required field is missing.
I agree to allow photos of myself/child, which have been taken whilst partaking in equestrian activities at Kilcoy Working Cow Horse Club Inc. to be used in advertising and social media web pages including the sharing of results. *	Please enter a valid date Required field is missing.

Email address is already assigned to a member,
please use an alternative email address.

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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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