Murrumbateman Pony Club 8 Hercules Street, Murrumbateman NSW 2582
Murrumbateman Pony Club 8 Hercules Street, Murrumbateman NSW 2582
MEMBERSHIP APPLICATION/RENEWAL
Personal details
Name/s(First Name, SURNAME)(List all people that are to be members, children & adults
Certificate level only for junior and associate riders) / DOB
(dd/mm/yyyy) / Gender
(please circle) / Riding or Nonriding
(please state) / PCA Certificates achieved
( please circle)
M / F / E D D* C C* K B A
M / F / E D D* C C* K B A
M / F / E D D* C C* K B A
M / F / E D D* C C* K B A
M / F / E D D* C C* K B A
M / F / E D D* C C* K B A
M / F / E D D* C C* K B A
New Member Renewing Transferring to MPC – please complete transfer paper in triplicate & include with membership.
Address:
Phone: / Main: / alternate: / Preferred contact method (please circle)
Email Facebook text
Email address: (this, FB and the website are the main sources of communication)
Agreement to the terms of Membership with Murrumbateman Pony Club:
Murrumbateman Pony Club provides excellent facilities and low membership costs thanks to the fundraising efforts of all club members.I understand that when joining Murrumbateman Pony Club
- I agree to provide, as a minimum, the following assistance to support the club:
- Assistance at each Rally Daysthat your child attends(it is an MPC requirement that a guardian is present when your child is at MPC events)and
- Two half or one full day support to MPC events (SJF, Gymkhana’s etc)
- I agree that should my child be injured or fall ill, Murrumbateman Pony Club, at the discretion of a Club Official, may seek medical assistance and/or if deemed necessary, move my child to the nearest public hospital via ambulance.
- Applicants MAY NOT ride with the club until their horse and gear have been inspected and cleared by the Senior Instructor and all membership forms have been completed correctly, returned to club and fees have paid. Membership fees also cover compulsory PCA insurance and affiliation fees to PCANSW. Please note insurance cover on Rally Days does not commence until after gear check and does not cover members riding to and from Rally Days. Horses and Riders participate at their own risk. Murrumbateman Pony Club accepts no liability for any loss, damages or injury to any person, horse or property.
- I give permission for my child’s photo to be used in the clubs newsletter, website and local mediaY/N
(if no please complete application for exemption to photograph/video/film of a member in the Photography Policy from NSWPCA website).
Signature (Parent/Guardian) Date