Membership Application Form

Membership Form 2022/2023

* denotes Required Field
Applicant's Name *

First Name Last Name
E-mail Address *
Postal Address *

Street Address

Street Address Line 2

City State / Province

Post Code Country
Phone Number (AH)

Area Code Phone Number
Phone Number (Mobile)
Riding Level (optional)
Occupation (optional)
Membership Type *

Single Riding Member $60 Junior Riding Member (twelve to seventeen years of age) $40 Family Membership (includes your spouse and children under eighteen years of age) $80 Non Riding Membership $40
Joining Fee

I am a new member or am rejoining after a period of absence of six months or more (additional $11 fee applies)
Agreement *

I wish to renew/apply for membership of the Yarra Valley Dressage Club Incorporated for the period of 1st July 2022 to 30th June 2023. I agree to be bound by the rules of the association for the time being in force and commit to help at Club official competitions and functions.
Total Payment $ *
Payment Method *

EFT - BSB 633 000 Account: 120 534 870 Yarra Valley Dressage Club Inc; Reference – Surname plus Month and year of competition
Should be Empty:

Membership Form 2022/2023