Transcript Mount Barker Adult Riding Club Annual General Meeting 2009

Mount Barker Adult Riding Club
Membership/Renewal form
Name: _______________________________
Address: _____________________________
_____________________________________
_____________________________________
Ph no: _______________________________
Mobile no: ____________________________
Email : _______________________________
PIC No: ______________________________
Fees for 2013/14 riding year (1 Oct – 30 Sep)
Riding members: $90 (full year) *No Joining Fee*
Non-riding members: $25
(Please notify President if you do not have access to email, as this is the only way we will be
registering rallies going forward. We will recommend you “buddy up” with another member.
Otherwise it will be your responsibility to contact the Secretary each month to register)
Date of Birth: _________________________ Equestrian SA Membership No. _______________
Membership type: Riding ______ Non-Riding _______ Total: $_________
Medical details (who should we contact in an emergency?):
Contact name: __________________________ Ph no: __________________
Doctor’s name: __________________________ Ph no: __________________
Do you have any medical conditions we should be aware of? Yes ______ No _______
If “yes”, please specify: __________________________________________________________
Vet’s name: _____________________ Ph no: __________________
(all attempts will be made to contact your preferred vet on your behalf, in an emergency. If we are
unable to contact your vet, we will then arrange for the first available veterinary surgeon to attend to
your horse)
Membership is not valid until approved by the committee. If the application should cause the club to
exceed membership limit, you will be placed on the waiting list, and notified as soon as a spot
becomes available. Please make sure you are familiar with the Mount Barker Adult Riding Club
Handbook, and your responsibilities as a Club Member, as you agree to all rules on signing this
membership application. Please note that a condition of your membership is that you make
yourself available to assist the Committee at a minimum of one rally during the riding year.**
Signature of applicant: ____________________________ Date: _________________________
Please note an EFA disclaimer form must be signed, and your helmet must be checked by a
committee member before your first ride.
Payment can be made by cash, cheque or EFT (BSB 105-900, Account 171762940, Mt Barker
Adult Riding Club). If using EFT, please put your name as the bank reference.
**Please indicate below the rallies you are available to assist (circle the month):
Oct 2013
Apr 2012
Nov 2013
May 2014
Dec 2013
Jun 2014
Jan 2014
Jul 2014
Feb 2014
Aug 2014
Mar 2014
Sep 2014