EmailMe Form - Waitemata Riding Club Inc

Name *
First Last
Email *
Mobile Phone
Horse competition name (1)
Horse competition name (2)
Horse competition name (3)
Register me for
Newcomer Cup (see website for definition)
Young Horse Cup (Horse 6 years or under on 1 Aug 2018)
Old Horse Cup (Horse 21 years or over on 1 Aug 2018)
Name and Date of Birth of Young/Old Horse
$40 membership fee paid by
Internet to ANZ Bank 06 0254 0001134 00
Cheque
Cash
Date Paid
DD / MM / YYYY
I confirm I am over 21 years
Yes
Additional Comments
File Upload