Clubs

Mersey Valley Pony Club

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Member Details

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First Name*

Last Name*

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Alternate Email1

Alternate Email2

Residential Address

Address*

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Home Phone*

Mobile*

Mailing Address

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Other information

Previous Membership if any:	Please enter a valid date
Riders Age	Please enter a valid date
Horse Details	Please enter a valid date
Age:	Please enter a valid date
Height:	Please enter a valid date
Horse Name:	Please enter a valid date
Age:	Please enter a valid date
Height	Please enter a valid date
Horse Name:	Please enter a valid date
Horse agisted at: (if not at home address)	Please enter a valid date
It is PCAT Policy for all non-riding adults who regularly attend Pony Club to have a Working With Children Check (WWC) *	Please enter a valid date Required field is missing.
If you have a WWC, please provide the number and expiry date	Please enter a valid date
PCAT Certificates:	Please enter a valid date
Please advise here if you do NOT want photos of yourself/rider/other family member publicised.	Please enter a valid date
Any skiills or other attributes that might be useful to the club?	Please enter a valid date