West Gippsland Quarter Horse Association Inc.

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
Please ensure all required fields are filled before submitting this form.

Competing Sectors:
Memberships:
Membership Level
Renewal must be consecutive years. New members must be approved by the committee.


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.


In Case of Emergency:


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