Gidgegannup Equestrian Association

Adult Riding Club

2021 Mid Year Membership Enrolment Form

Welcome to Gidgegannup Equestrian Association

Mid year membership $85

The Mid Year Membership Form can be completed on line

or download the pdf version in the Membership Information Package and send to:

gidgearc@yahoo.com.au or

Gidgegannup Equestriain Association Inc.

PO Box 77, Gidgegannup, WA, 6083

Mid Year Membership taked effect from July 1st

EFT Reference Code: (MidMship-Surname)

A signed waiver form must accompany your application

Name
Address
Phone
Email Address:
Facebook Name
Birthday
EWA Membership Number (if applicable)
Type of EWA Membership
- Competitor
- Participant
GEA Membership
- Mid Year Full Membership $85
Amount paid
Date of transfer
EFT Ref (SurnameMembership)
Payment Method
- EFT (prefered)
- Cheque
- Money Order
I hereby apply to become a member of Gidgegannup Equestrian Association and confirm that I have read and understand the terms and conditions as outlined in the GEA Information pack. I declare I am 18 years of age or over. I have signed the EWA waiver form.
- Agree
- Disagree
Emergency Contact
Phone
Emergency Contact
Phone
Rider's Medical Conditions (Confidential)
Regular Medications
Allergies (Please specify)
Medicare Number
Private Ambulance Insurance
Rider's Experience (tick as many boxes as applicable)
- Green/inexperienced
- walk/trot
- walk/trot/canter
- Pony Club
- ARC
Dressage Level (if applicable)
- Preparatory
- Prelim
- Novice
- Elementary & above
Show Jumping (if applicable)
- Beginner (under 50 cm)
- 50-60 cm
- 60-75 cm
- 80+ cm
Disciplines
- Eventing
- Endurance
- Games/Agility
- Western Riding
- Natural Horsemanship
- Dressage
- Showjumping
Other
Horse's Name 1
Horse's Experience (tick as many boxes as applicable)
- green/Inexperienced
- walk/trot
- walk/trot/canter
- Pony Club
- ARC
Dressage Level (if applicable)
- Preparatory
- Prelim
- Novice
- Elementary & above
Show Jumping (if applicable)
- Beginner (under 50 cm)
- 50-60 cm
- 60-75 cm
- 80+ cm
Disciplines
- Eventing
- Endurance
- Games/Agility
- Western Riding
- Natural Horsemanship
- Dressage
- Showjumping
Other
Horse's Name 2
Horse's Experience (tick as many boxes as applicable)
- green/Inexperienced
- walk/trot
- walk/trot/canter
- Pony Club
- ARC
Dressage Level (if applicable)
- Preparatory
- Prelim
- Novice
- Elementary & above
Show Jumping (if applicable)
- Beginner (under 50 cm)
- 50-60 cm
- 60-75 cm
- 80+ cm
Disciplines
- Eventing
- Endurance
- Games/Agility
- Western Riding
- Natural Horsemanship
- Dressage
- Showjumping
Other
Any other information you consider relevant to place horse and rider in the appropriate group (e.g.horse has never cantered in a group)
Send Message

Thank you and welcome to GEA!
Please remember to submit the Waiver and Membership Forms individually.

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PAYMENT DETAILS

Membership form can be completed on line.

or download the pdf version and send to:

gidgearc@yahoo.com.au or

Gidgegannup Equestriain Association Inc.

PO Box 77, Gidgegannup, WA, 6083

EFT Details:

Bendigo Bank

BSB: 633-000 ACCOUNT No: 150137297

ACCOUNT NAME: Gidgegannup Equestrian

EFT Reference Code: (MidMship- Surname)

Waiver Form

GEA Rules & Regulations

EA Rules & Regulations

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