NZCCA Membership - New or Renewal

NZCCA Membership - New or Renewal

2019-20 Season
Type *

New member application (one application per person unless a family application) Membership renewal
Name *

First Name Last Name
Other names if Family subscription only:
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number

Address *

Membership type *

Adult $35 Youth $25 Family $80
List any other horse clubs/organisations you belong to:
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 Date Picker Icon
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 application / rewewal!
Payment *

Internet Cheque/cash
Should be Empty: