NZCCA Membership - Membership Renewal

NZCCA Membership Renewal

2020-21 Season
One application per person please, unless a Family subscription.
Name *

First Name Last Name
Other names if Family subscription:
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Address *

Street Address

Street Address Line 2

Town/City

Post Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Membership type *

Adult $35 Youth $25 Family $80
I agree with the Objects of the NZCCA (refer Constitution) and will comply with its rules and policies: *

I agree to all terms
Date *

Day Month Year
Date
Preferred payment of membership fee is by direct deposit to:
Bank: Westpac. Acc No: 03-0887-0493175-000

Name: NZ Cowboy Challenge Association Inc

Reference: Name and "Membership"

If payment is by cheque or cash please contact nzccassn@gmail.com for postage details

Thank you for your membership renewal and ongoing support.
Payment *

Internet Cheque/cash
Should be Empty:

NZCCA Membership Renewal