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Last Name*

Date Of Birth*

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Alternate Email1

Alternate Email2

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Please select Rider Age Group *

I give permission to Baroomby Greta Riding Club inc to obtain and use photos of myself, my child, and/and or any other person mentioned in this membership application in any and all publications which may include social media platforms, newsletters, promotions etc. *

Yes

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

You appear to be an existing member.
Do you want to renew your membership?

Primary member must be over 18 years of age.

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.

Baroomby Greta Riding Club Inc

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