Online Membership Renewal – EFT and Cheque/MO Membership Renewal - EFT and Cheque/MO only Version 3 - June 2023 Your age* 18 Years and over 16 to 18 years Membership Number* Troop AHLA Members DetailsMembership type* Riding Member $85 ATA Tentpegging Riding Member $60 Non-riding member $60 Personal DetailsTitle* Name* First Last Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address* Street Address Address Line 2 City State Postcode Mobile Phone Home Phone Email Firearms Permit - if applicablePermit Number State Expiry Date DD slash MM slash YYYY Member DeclarationYour full name* By renewing my membership 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 declarationApplicants Signature*Parent/Guardian Signature where applicableYour declaration must be done in hardcopy form. Please download hard copy, complete and have your parent or guardian sign PaymentI am paying by - (please note our NEW BSB No: 654 000 and update your saved banked details as required) :* EFT Cheque/MO Cheque/Money Order -Payable to The Australian Light Horse Assoc. Cheque Mail To: Membership Registrar. PO Box 6184 QUEANBEYAN EAST NSW 2620 Payment must be included with or made at time of Renewal Direct Deposit - The Australian Light Horse Assoc. Branch: BSB 654 000 Account Number: 32006425 Please include Name and number Total $ 0.00 Membership does not take effect until your renewal has been received, bank cleared, and Insurance processed. This may take up to 2 weeks.Other PhoneThis field is for validation purposes and should be left unchanged.