Online Membership Application – EFT and Cheque/MO – Australian Light Horse Association

Please note this form uses conditional logic. Choices made as you progress will reveal or hide additional fields that need your input. Because of this it is best to work from the top down.

Your age*

18 Years and over
16 to 18 years

Membership type*

Riding Member $85
ATA Tentpegging Riding Member $60
Non-riding member $60

Title*

Name*

First Last

Address*

Street Address Address Line 2 City State Postcode

Mobile Phone

Home Phone

Email

Date of birth*

Occupation

Riding Experience if applicable

Years

Riding experience if applicable

more detail if required

Riding Experience level if applicable

Experienced / Competitor
Recreational
Novice / Beginner

Horse details if applicable

Black, Brown, Bay & Chestnut. No Stallions or Rigs permitted

Re-enactment Troop

if applicable

Firearms - If applicable

Permit Number

State

Expiry Date

General questions

Reason for application

eg: interest in military history etc

I am a member of the following organisations / related interests

if applicable

Member Declaration

Your full name*

I hereby apply to become a member of the Australian Light Horse Association Ltd*

I agree to abide by the Rules and Regulations of the Association (Available on our website.)
I declare that the details I have provided regarding my personal information are true and correct.
I acknowledge that Membership does include Personal Accident Insurance.
I understand that the Public Liability insurance only covers Members in Australia and othernominated locations (as stated in the policy) engaging in Light Horse activities. The renewal cycle forthe Association is from the 1st of July to the 30th June the following year and pro rata rates do notapply. Copies of the Association magazine"Spur " will be forwarded to the above address each year.
I acknowledge that horse sport is dangerous and that accidents causing death, bodily injury,disability and property damage can, and do happen. I acknowledge the inherent risk associated withhorses and equine activities.
I acknowledge and agree that neither ALHA nor “the organizers” shall be under any liability fordeath, or bodily injury, loss or damage which may be sustained or incurred by the applicant, as aresult of participation in or being present at ALHA endorsed events, except in regard to any rights Imay have arising under the Trade Practices Act or State Laws.
I acknowledge that I have read and understood the information provided in this membership formand on the ALHA website regardingcodes of conduct, training and presentation.
Agreed

Applicants Signature*

16 to 18 year old member declaration

Parent/Guardian details - where applicable

Name

Title First Last

Address

Street Address Address Line 2 City State Postcode

Applicants Signature

Parent/Guardian Signature where applicable

Your declaration must be done in hardcopy form. Please download hard copy, complete and have your parent or guardian sign

Nominations

WE HEREBY NOMINATE THE ABOVE MENTIONED CANDIDATE AS A MEMBER OF THE ALHA LTD AND IN DOING SO BELIEVE THE CANDIDATE IS IN EVERY RESPECT ELIGIBLE ACCORDING TO THE RULES AND FIT FOR MEMBERSHIP

Proposer (1)

Member No

Troop

Proposer (2)

Member No

Troop

Total

$ 0.00

Membership does not take effect until your application has been received, passed and bank cleared

Payment

I will pay by (please note our NEW BSB No: 654 000):*

EFT
Cheque/MO

Cheque/Money Order - Payable to The Australian Light Horse Assoc. Cheque/MO Mail To: Membership Registrar. PO Box 6184 QUEANBEYAN EAST NSW 2620 Payment must be included with or made at time of Application. Direct Deposit - The Australian Light Horse Assoc. Branch: BSB 654 000 Account Number: 32006425 Please include Name

Other