Member Application/Renewal IMPORTANT Before filling out this form please read and understand Liability and Waiver Agreement: Click here to view the Liability and Waiver Agreement Accept Conditions Accept conditions I/we declare that I/we have read, understood and agreed to the terms and conditions as outlined in the Liabilities and Waiver Agreement and understand the rules for highpoint. By submitting this form and paying the required membership fee, I/we agree to abide by the Constitution and Rules and Regulations outlined by the WGQHA Inc. and affiliated AQHA. Please ensure all required fields are filled before submitting this form.Competing Sectors: Competing Sectors Performance Cutting Team Penning Extreme Cowboy Competing Sectors Performance Cutting Team Penning Extreme Cowboy Memberships: Membership Level Membership Level Youth $15 Single $30 Family $45 Life Membership Renewal Renewal New Member Renewal must be consecutive years. New members must be approved by the committee. Name Address Town/City State Postcode Email Phone AQHA No. NCHA No. EXCA No. For family memberships, please list all names below. (NOTE: Family Membership consists of 2nd adult as spouse and youth 19 years and below and must reside at the same address as listed above) Parent/Legal Gudian must be Present with Youth At all Times. Adult 2 Youth 1 Date - Youth 1 Youth 2 Date - Youth 2 Youth 3 Date - Youth 3 In Case of Emergency: Emergency Name Emergency Phone Payment details: Please make your membership payment using the following bank account details and complete the payment confirmation form below: BSB: 633 000 Account: 181266560 Account Name Date of Payment Bank Name Bank Receipt Send membership application
